<SEC-DOCUMENT>0001193125-19-040891.txt : 20190214
<SEC-HEADER>0001193125-19-040891.hdr.sgml : 20190214
<ACCEPTANCE-DATETIME>20190214162117
ACCESSION NUMBER:		0001193125-19-040891
CONFORMED SUBMISSION TYPE:	10-K
PUBLIC DOCUMENT COUNT:		95
CONFORMED PERIOD OF REPORT:	20181231
FILED AS OF DATE:		20190214
DATE AS OF CHANGE:		20190214

FILER:

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

	FILING VALUES:
		FORM TYPE:		10-K
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-12111
		FILM NUMBER:		19606714

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

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

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	PEDIATRIX MEDICAL GROUP INC
		DATE OF NAME CHANGE:	19950801
</SEC-HEADER>
<DOCUMENT>
<TYPE>10-K
<SEQUENCE>1
<FILENAME>d671465d10k.htm
<DESCRIPTION>10-K
<TEXT>
<HTML><HEAD>
<TITLE>10-K</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>

 <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:3pt; 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="margin-top:6pt; margin-bottom:0pt; font-size:18pt; font-family:Times New Roman" ALIGN="center"><B>Form <FONT STYLE="white-space:nowrap">10-K</FONT> </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>&#9746;<B></B><B></B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:12pt; font-family:Times New Roman; " ALIGN="left"><B>ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
</B></P></TD></TR></TABLE> <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:12pt; font-family:Times New Roman"><B>For the fiscal year ended December&nbsp;31, 2018 </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"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:12pt; font-family:Times New Roman; " ALIGN="left"><B>TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
</B></P></TD></TR></TABLE> <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:12pt; font-family:Times New Roman"><B>For the transition period from
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;to&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:12pt; 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>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:9pt" ALIGN="center">


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


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<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"><B>(State or other jurisdiction<BR>of incorporation or organization)</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"><B>(I.R.S. Employer<BR>Identification No.)</B></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:9pt">
<TD VALIGN="top" ALIGN="center"><B>1301 Concord Terrace, Sunrise, Florida</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" 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:9pt; font-family:Times New Roman" ALIGN="center"><B>Registrant&#146;s telephone number, including area code (954) <FONT STYLE="white-space:nowrap">384-0175</FONT>
</B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:9pt; font-family:Times New Roman" ALIGN="center"><B>Securities registered pursuant to Section&nbsp;12(b) of the Act: </B></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:8pt" ALIGN="center">


<TR>
<TD WIDTH="49%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="47%"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<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>Title of Each Class</B></P></TD>
<TD VALIGN="bottom">&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>Name of Each Exchange on Which
Registered</B></P></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top" ALIGN="center"><B>Common Stock, par value $.01 per share</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"><B>New York Stock Exchange</B></TD></TR>
</TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:9pt; font-family:Times New Roman" ALIGN="center"><B>Securities registered pursuant to Section&nbsp;12(g) of the Act: None </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:3%; font-size:9pt; font-family:Times New Roman">Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities
Act.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Yes&nbsp;&nbsp;&#9746;&nbsp;&nbsp;&nbsp;&nbsp;No&nbsp;&nbsp;&#9744; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:3%; font-size:9pt; font-family:Times New Roman">Indicate by check mark if the
registrant is not required to file reports pursuant to Section&nbsp;13 or Section&nbsp;15 (d) of the Exchange Act.&nbsp;&nbsp;&nbsp;&nbsp;Yes&nbsp;&nbsp;&#9744;&nbsp;&nbsp;&nbsp;&nbsp;No&nbsp;&nbsp;&#9746; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:3%; font-size:9pt; 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:3%; font-size:9pt; font-family:Times New Roman">Indicate by check mark whether the
registrant has submitted electronically every Interactive Data File required to be submitted 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 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:3%; font-size:9pt; font-family:Times New Roman">Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation <FONT STYLE="white-space:nowrap">S-K</FONT>
(&#167;229.405 of this chapter) is not contained herein, and will not be contained, to the best of registrant&#146;s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form <FONT
STYLE="white-space:nowrap">10-K</FONT> or any amendment to this Form <FONT STYLE="white-space:nowrap">10-K.&nbsp;&nbsp;&#9744;</FONT> </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:3%; font-size:9pt; 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, a smaller reporting company, or an emerging growth company. See the definitions of &#147;large accelerated filer,&#148; &#147;accelerated filer,&#148; &#147;smaller reporting
company,&#148; and &#147;emerging growth company&#148; in Rule <FONT STYLE="white-space:nowrap">12b-2</FONT> of the Exchange Act. </P> <P STYLE="font-size:6pt;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:9pt" ALIGN="center">


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="bottom">Large accelerated filer&nbsp;&nbsp;&#9746;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">Accelerated&nbsp;filer&nbsp;&nbsp;&#9744;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><FONT STYLE="white-space:nowrap">Non-accelerated&nbsp;filer&nbsp;&nbsp;&#9744;</FONT></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">Smaller&nbsp;reporting&nbsp;company&nbsp;&nbsp;&#9744;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="4"></TD>
<TD HEIGHT="4" COLSPAN="2"></TD>
<TD HEIGHT="4" COLSPAN="2"></TD>
<TD HEIGHT="4" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">Emerging&nbsp;growth&nbsp;company&nbsp;&nbsp;&#9744;</TD></TR>
</TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:3%; font-size:9pt; 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:3%; font-size:9pt; font-family:Times New Roman">Indicate by check mark whether the registrant is a shell company (as defined by Rule <FONT STYLE="white-space:nowrap">12b-2</FONT> of the
Exchange Act).&nbsp;&nbsp;&nbsp;&nbsp;Yes&nbsp;&nbsp;&#9744;&nbsp;&nbsp;&nbsp;&nbsp;No&nbsp;&nbsp;&#9746; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:3%; font-size:9pt; font-family:Times New Roman">The aggregate market value of
shares of Common Stock of the registrant held by <FONT STYLE="white-space:nowrap">non-affiliates</FONT> of the registrant on June&nbsp;30, 2018, the last business day of the registrant&#146;s most recently completed second fiscal quarter, was
$3,943,237,534 based on a $43.28 closing price per share as reported on the New York Stock Exchange composite transactions list on such date. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:3%; font-size:9pt; font-family:Times New Roman">The number of shares of Common Stock of the registrant outstanding on February&nbsp;7, 2019 was 87,920,463. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:9pt; font-family:Times New Roman" ALIGN="center"><B>DOCUMENTS INCORPORATED BY REFERENCE: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:3%; font-size:9pt; font-family:Times New Roman">The registrant&#146;s definitive proxy statement to be filed with the Securities and Exchange Commission pursuant to Regulation 14A, with
respect to the 2019 Annual Meeting of Shareholders is incorporated by reference in Part III of this <FONT STYLE="white-space:nowrap">Form&nbsp;10-K</FONT> to the extent stated herein. Except with respect to information specifically incorporated by
reference in the <FONT STYLE="white-space:nowrap">Form&nbsp;10-K,</FONT> each document incorporated by reference herein is deemed not to be filed as part hereof. </P> <P STYLE="font-size:6pt;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>

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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ANNUAL REPORT ON FORM <FONT STYLE="white-space:nowrap">10-K</FONT> </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>For the Year Ended December&nbsp;31, 2018 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="toc"></A>INDEX </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B><A HREF="#tx671465_1a">PART&nbsp;I</A></B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;1.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_1">Business</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;1A.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_2">Risk Factors</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">28</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;1B.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_3">Unresolved Staff Comments</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">44</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;2.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_4">Properties</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">44</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;3.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_5">Legal Proceedings</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">44</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;4.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_6">Mine Safety Disclosures</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">44</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B><A HREF="#tx671465_6a">PART&nbsp;II </A></B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;5.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_7">Market for Registrant&#146;s Common Equity, Related Stockholder Matters and
 Issuer Purchases of Equity Securities</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">45</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;6.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_8">Selected Financial Data</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">48</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;7.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_9">Management&#146;s Discussion and Analysis of Financial Condition and Results
 of Operations</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">49</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;7A.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_10">Quantitative and Qualitative Disclosures About Market Risk</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">65</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;8.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_11">Financial Statements and Supplementary Data</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">66</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;9.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_12">Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">95</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;9A.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_13">Controls and Procedures.</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">95</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;9B.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_14">Other Information</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">96</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B><A HREF="#tx671465_14a">PART&nbsp;III </A></B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;10.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_15">Directors, Executive Officers and Corporate Governance</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">97</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;11.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_16">Executive Compensation</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">97</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;12.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_17">Security Ownership of Certain Beneficial Owners and Management and Related
 Stockholder Matters</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">97</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;13.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_18">Certain Relationships and Related Transactions, and Director Independence</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">97</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;14.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_19">Principal Accounting Fees and Services</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">98</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B><A HREF="#tx671465_19a">PART&nbsp;IV </A></B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;15.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_20">Exhibits, Financial Statement Schedule</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">99</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">&nbsp;</TD>
<TD VALIGN="top">Item&nbsp;16.</TD>
<TD NOWRAP VALIGN="top">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx671465_21">Form <FONT STYLE="white-space:nowrap">10-K</FONT> Summary</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">103</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FORWARD-LOOKING STATEMENTS </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Certain information included or incorporated by reference in this Form <FONT STYLE="white-space:nowrap">10-K</FONT> may be deemed to be
&#147;forward-looking statements&#148; which may include, but are not limited to, statements relating to our objectives, plans and strategies, and all statements (other than statements of historical facts) that address activities, events or
developments that we intend, expect, project, believe or anticipate will or may occur in the future. These statements are often characterized by terminology such as &#147;believe,&#148; &#147;hope,&#148; &#147;may,&#148; &#147;anticipate,&#148;
&#147;should,&#148; &#147;intend,&#148; &#147;plan,&#148; &#147;will,&#148; &#147;expect,&#148; &#147;estimate,&#148; &#147;project,&#148; &#147;positioned,&#148; &#147;strategy&#148; and similar expressions, and are based on assumptions and
assessments made by our management in light of their experience and their perception of historical trends, current conditions, expected future developments and other factors they believe to be appropriate. Any forward-looking statements in this Form
<FONT STYLE="white-space:nowrap">10-K</FONT> are made as of the date hereof, and we undertake no duty to update or revise any such statements, whether as a result of new information, future events or otherwise. Forward-looking statements are not
guarantees of future performance and are subject to risks and uncertainties. Important factors that could cause actual results, developments and business decisions to differ materially from forward-looking statements are described in this Form <FONT
STYLE="white-space:nowrap">10-K,</FONT> including the risks set forth under &#147;Risk Factors&#148; in Item 1A. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">2 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As used in this Form <FONT STYLE="white-space:nowrap">10-K,</FONT> unless the context otherwise
requires, the terms &#147;MEDNAX,&#148; the &#147;Company,&#148; &#147;we,&#148; &#147;us&#148; and &#147;our&#148; refer to the parent company, MEDNAX, Inc., a Florida corporation, and the consolidated subsidiaries through which its businesses are
actually conducted (collectively, &#147;MDX&#148;), together with MDX&#146;s affiliated business corporations or professional associations, professional corporations, limited liability companies and partnerships (&#147;affiliated professional
contractors&#148;). Certain subsidiaries of MDX have contracts with our affiliated professional contractors, which are separate legal entities that provide physician services in certain states and Puerto Rico. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx671465_1a"></A>PART I </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="9%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_1"></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>BUSINESS </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>OVERVIEW </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">MEDNAX is a leading provider of
physician services including newborn, anesthesia, maternal-fetal, radiology and teleradiology, pediatric cardiology and other pediatric subspecialty care. At December&nbsp;31, 2018, our national network comprised over 4,210 affiliated physicians,
including 1,270 physicians who provide neonatal clinical care, primarily within hospital-based neonatal intensive care units (&#147;NICUs&#148;), to babies born prematurely or with medical complications. We have 1,315 affiliated physicians who
provide anesthesia care to patients in connection with surgical and other procedures, as well as pain management. In addition, we have 365 affiliated physicians who provide maternal-fetal and obstetrical medical care to expectant mothers
experiencing complicated pregnancies primarily in areas where our affiliated neonatal physicians practice. Our network also includes other pediatric subspecialists, including 190 physicians providing pediatric intensive care, 110 physicians
providing pediatric cardiology care, 140 physicians providing hospital-based pediatric care, 25 physicians providing pediatric surgical care, and 10 physicians providing pediatric ear, nose and throat and pediatric ophthalmology services. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">MEDNAX also provides radiology services through a network of over 355 affiliated physicians, as well as teleradiology services through a
network of 430 affiliated physicians. In addition to our national physician network, we provide services to healthcare facilities and physicians, including ours, through complementary businesses, consisting of a management services organization
focusing on full-service revenue cycle management and a consulting services company. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">MEDNAX, Inc. was incorporated in Florida in 2007 and
is the successor to Pediatrix Medical Group, Inc., which was incorporated in Florida in 1979. Our principal executive offices are located at 1301 Concord Terrace, Sunrise, Florida 33323 and our telephone number is (954) <FONT
STYLE="white-space:nowrap">384-0175.</FONT> </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>OUR PHYSICIAN SPECIALTIES AND SERVICES </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following discussion describes our physician specialties and the care that we provide: </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Neonatal Care </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We provide clinical care
to babies born prematurely or with complications within specific units at hospitals, primarily NICUs, through our network of affiliated neonatal physician subspecialists (&#147;neonatologists&#148;), neonatal nurse practitioners and other pediatric
clinicians who staff and manage clinical activities at more than 400 NICUs in 36 states and Puerto Rico. Neonatologists are board-certified, or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">eligible-to-apply-for-certification,</FONT></FONT></FONT></FONT> physicians who have extensive education and training for the care of babies born prematurely or with complications that require complex medical treatment.
Neonatal nurse practitioners are registered nurses who have advanced training and education in assessing and treating the healthcare needs of newborns and infants as well as managing the needs of their families. </P>
 <p STYLE="margin-top: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>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We partner with our hospital clients in an effort to enhance the quality of care delivered to
premature and sick babies. Some of the nation&#146;s largest and most prestigious hospitals, including both <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">not-for-profit</FONT></FONT> and
<FONT STYLE="white-space:nowrap">for-profit</FONT> institutions, retain us to staff and manage their NICUs. Our affiliated neonatologists generally provide <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">24-hours-a-day,</FONT></FONT></FONT> <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">seven-days-a-week</FONT></FONT> coverage in NICUs, support the local referring physician community and are available
for consultation in other hospital departments. Our hospital partners benefit from our experience in managing complex intensive care units. Our neonatal physicians interact with colleagues across the country through an internal communications system
to draw upon their collective expertise in managing challenging patient-care issues. Our neonatal physicians also work collaboratively with maternal-fetal medicine subspecialists to coordinate the care of mothers experiencing complicated pregnancies
and their fetuses. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Anesthesia and Anesthesia Subspecialty Care </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We provide anesthesia care at over 150 hospitals, 155 ambulatory surgery centers and office-based practices across 15 states. Following the
&#147;care team&#148; model, our affiliated anesthesiologists work with both practice and hospital-employed certified registered nurse anesthetists (&#147;CRNAs&#148;), anesthesiologist assistants (&#147;AAs&#148;) and other clinicians to provide
high quality, cost efficient and service-oriented anesthesia care to our patients. Our anesthesiologists are board-certified, or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">eligible-to-apply-for-certification,</FONT></FONT></FONT></FONT> physicians who are responsible for administering anesthesia to relieve pain and for managing vital life functions during surgery, including breathing, heart
rhythm and blood pressure. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As an integral part of the surgical team, our affiliated anesthesiologists support the surgeons by providing
medical care before, during and after surgery so that surgeons may concentrate on the surgical procedure. Our affiliated anesthesiologists provide this care by evaluating the patient and consulting with the surgical team before surgery, providing
pain control and support of life functions during surgery, supervising care after surgery by maintaining the patient in a comfortable state during recovery and discharging the patient from the post-anesthesia care unit. They also support other
departments within the hospital such as labor and delivery, imaging and the hospital&#146;s emergency room. In addition to their board certification in anesthesiology, many of our affiliated anesthesiologists have completed fellowships in
subspecialties such as obstetrical, critical care, cardiac and pediatric anesthesia. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Pain Management </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We also provide acute and chronic pain management services in over 30 pain management centers through our network of affiliated physicians and
physician assistants. Our affiliated physicians are board-certified in anesthesiology or neurology and board-certified, or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">eligible-to-apply-for-certification,</FONT></FONT></FONT></FONT> in pain medicine. This advanced training and education expands treatment options available for both acute and chronic pain sufferers. The physicians develop
treatment plans specific to the patients&#146; individual needs that include interventional techniques such as trigger point and facet injections, pain pumps, nerve stimulators, radiofrequency ablation and catheters, as well as medication
management. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Maternal-Fetal Care </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We
provide inpatient and office-based clinical care to expectant mothers and their unborn babies through our affiliated maternal-fetal medicine subspecialists as well as obstetricians and other clinicians, such as maternal-fetal nurse practitioners,
certified nurse <FONT STYLE="white-space:nowrap">mid-wives,</FONT> ultrasonographers and genetic counselors. Maternal-fetal medicine subspecialists are board-certified, or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">eligible-to-apply-for-certification,</FONT></FONT></FONT></FONT> obstetricians who have extensive education and training for the treatment of high-risk expectant mothers and their fetuses.
Our affiliated maternal-fetal medicine subspecialists practice primarily in metropolitan areas where we have affiliated neonatologists to provide coordinated care for women with complicated pregnancies whose babies are often admitted to a NICU upon
delivery.<B> </B>We believe continuity of treatment from mother and developing fetus during the pregnancy to the newborn upon delivery has improved the clinical outcomes of our patients. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">4 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Pediatric Cardiology Care </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We provide inpatient and office-based pediatric cardiology care of the fetus, infant, child and adolescent patient with congenital heart
defects and acquired heart disease, as well as adults with congenital heart defects through our affiliated pediatric cardiologist subspecialists and other related clinical professionals such as pediatric nurse practitioners, echocardiographers,
other diagnostic technicians, and exercise physiologists. Pediatric cardiologists are board-certified, or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">eligible-to-apply</FONT></FONT> for certification, pediatricians who have
additional education and training in congenital heart defects and pediatric acquired heart disorders. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We provide specialized cardiac care
to the fetus, neonatal and pediatric patients with congenital and acquired heart disorders, as well as adults with congenital heart defects, through scheduled office visits, hospital rounds and immediate consultation in emergency situations. Our
affiliated pediatric cardiologists work collaboratively with neonatologists and maternal-fetal medicine subspecialists to provide a coordinated continuum of care. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Other Pediatric Subspecialty Care </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our
network includes other pediatric subspecialists such as pediatric intensivists, pediatric hospitalists, pediatric surgeons and pediatric ear, nose and throat physicians. In addition, our affiliated physicians seek to provide support services in
other areas of hospitals, particularly in the pediatric emergency room, labor and delivery area, and nursery and pediatric departments, where immediate accessibility to specialized care may be critical. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Pediatric Intensive Care</I></B>. Pediatric intensivists are hospital-based pediatricians with additional education and training in
caring for critically ill or injured children and adolescents. Our affiliated physicians who provide this clinical care staff and manage pediatric intensive care units (&#147;PICUs&#148;) at approximately 65 hospitals. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Pediatric Hospitalists</I></B>. Pediatric hospitalists are hospital-based pediatricians specializing in inpatient care and management of
acutely ill children. Our affiliated hospital-based physicians provide this inpatient pediatric and newborn care in PICUs, NICUs and pediatric emergency rooms at approximately 45 hospitals. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Pediatric Surgery</I></B>. Pediatric surgeons provide specialized care for patients ranging from newborns to adolescents, for all
problems or conditions that require surgical intervention, and often have particular expertise in the areas of neonatal, prenatal, trauma, and pediatric oncology. Our affiliated physicians in this subspecialty include pediatric urologists, pediatric
plastic and craniofacial surgeons and general and thoracic pediatric surgeons. Areas of particular expertise include management of neonatal and congenital anomalies, prenatal counseling, trauma management, pediatric oncology, gastrointestinal
surgery, as well as common pediatric surgical conditions. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Other Newborn and Pediatric Care</I></B><I>.</I><B><I> </I></B>Because
our affiliated physicians and advanced nurse practitioners generally provide hospital-based coverage, they are situated to provide highly specialized care to address medical needs that may arise during a baby&#146;s hospitalization. For example, as
part of our ongoing efforts to support and partner with hospitals and the local referring physician community, our affiliated neonatologists, pediatric hospitalists and advanced nurse practitioners provide
<FONT STYLE="white-space:nowrap">in-hospital</FONT> nursery care to newborns through our newborn nursery program. This program is made available for babies during their hospital stay, which in the case of healthy babies typically consists of
evaluation and observation, following which they are referred, and their hospital records are provided, to their pediatricians or family practitioners for <FONT STYLE="white-space:nowrap">follow-up</FONT> care. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Newborn Hearing Screening Program</I></B><I>. </I>Our affiliated physicians also oversee our newborn hearing screening program. Since we
launched this program in 1994, we believe that we have become the largest provider of newborn hearing screening services in the United States. In 2018, we screened over 865,000 babies for potential hearing loss at 450 hospitals across the nation.
Over 40 states either require newborns to be screened </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">5 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
for potential hearing loss before being discharged from the hospital or require that parents be offered the opportunity to submit their newborns to hearing screens. We contract or coordinate with
hospitals to provide newborn hearing screening services. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Radiology and Teleradiology </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Radiology.</I></B><I> </I>We provide radiology services including diagnostic imaging, interventional radiology, women&#146;s imaging,
cardiac imaging and nuclear medicine, among others, through a network of over 355 affiliated physicians. We believe that we bring a unique value proposition to radiology physician groups, in that we can provide practice management support and a
technology platform enabling radiology to be practiced at a national level, as well as teleradiology capabilities that can enhance their efficiency, provide subspecialty access and help them to grow strategically and remain competitive while meeting
the demands of their hospital partners, third-party payors and regulatory bodies. In addition, we believe that radiology physicians in a group practice can complement the staffing needs for our teleradiology services business during certain times,
such as nights and weekends, when they are not providing services at their practices. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We recently launched two programs: the MEDNAX
Radiology Artificial Intelligence Incubator (&#147;AI Incubator&#148;) and the MEDNAX Radiology Centers of Excellence (&#147;Centers of Excellence&#148;). We expect the AI Incubator program to bring together radiologists, a rich and diverse clinical
dataset, and a growing ecosystem of partners to build future tools for radiology with the primary goal of improving patient care. Through a strong partnership between clinical and technical leadership as well as a key group of external partners with
shared goals, the program aims to improve the overall quality of patient care by increasing radiologists&#146; accuracy and efficiency, ultimately impacting patient outcomes. The Centers of Excellence program is designed to provide added value to
our hospital partners and patients alike, including continuous access to radiologist subspecialty expertise, world-class information technology and quality metrics for patient safety. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Teleradiology. </I></B>Teleradiology represents a component of the broader radiology industry whereby radiographic images are
transmitted from one location to another for interpretation. Through our vRad business, we provide teleradiology services to approximately 2,100 client hospitals, health systems and radiology groups across all 50 states, the District of Columbia and
Puerto Rico. With over 430 U.S. board-certified and eligible radiologists currently reading images in the network, the majority of whom are subspecialty trained, we are able to interpret over 6&nbsp;million patient studies annually and process over
2&nbsp;billion images on what we believe is the world&#146;s largest and most advanced telemedicine platform, which is covered by more than 18 patents. This telemedicine platform enables referring physicians to quickly and securely pass patient
imaging and information to radiologists, improving the speed, accuracy and cost of clinical diagnoses. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have also invested heavily in
cloud-based technology to develop our radiology workflow system that supports the distribution, prioritization and completion of imaging studies. Each component of our radiology workflow system, from our submittal process, to our post-diagnostic
analytics and benchmarking capabilities, provides evidence-based insight to help clients make better decisions for the health of patients and their practice of radiology. Our radiology workflow system allows for real-time personal connections
between our radiologists and our hospital, health system and radiology group partners. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We believe that teleradiology services are poised
for growth and that there are numerous opportunities for cross-selling vRad&#146;s services within MEDNAX&#146;s existing customer base. We believe that teleradiology will play a significant role in the practice of radiology in the future. Our
teleradiology business has continued to identify opportunities throughout the country for our radiology physician group practices to expand their presence, and we believe this is becoming a key differentiator as we continue building a broader
radiology business. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Management Services Organization </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">6 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
that offers full-service revenue cycle management solutions and innovative technology used for patient/physician connectivity as well as a consulting services company. Our management services
organization provides a suite of solutions including a range of patient access and communications, full-service revenue cycle management, consulting and analytics services, billing and coding, patient responsibility, eligibility and disability,
complex accounts receivable services such as workers&#146; compensation, <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-state</FONT></FONT> Medicaid eligibility and more, and mobile-first engagement and communication
software for patients and providers. Our solutions are designed to engage patients, empower physicians and hospitals and other healthcare providers and improve financial outcomes throughout the entire healthcare continuum. We provide these services
at more than 2,600 hospitals and other healthcare providers nationwide. In November 2018, we announced the initiation of a process to potentially divest our management services organization to allow us to focus our organization on our core physician
services business. However, there can be no assurance that this process will result in a transaction, and we may decide to retain all or part of the management services organization. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Consulting Services </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our perioperative
consulting company is comprised of a collaborative team of anesthesiologists, operating room nurse executives and perioperative business strategists who develop and provide solutions to optimize the performance, resources and capacity within
hospital operating rooms and across the care continuum. Our services include strategic assessments and transformations, central sterile redesign, physician engagement and governance, and staffing/workforce support. With our <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">peer-to-peer</FONT></FONT> consulting model, we partner with our clients to deliver sustainable and actionable results with the goal of streamlining patient throughput, enhancing anesthesia
service levels, increasing surgeon and patient satisfaction, decreasing costs and implementing strategic perioperative growth plans to hospitals and health systems. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Clinical Research, Education, Quality and Safety </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As part of our ongoing commitment to improving patient care through evidence-based medicine, we also conduct clinical research, monitor
clinical outcomes and implement clinical quality initiatives with a view to improving patient outcomes, shortening the length of hospital stays and reducing long-term health system costs. Our physician-centric approach to clinical research and
continuous quality improvement has demonstrated improvements in clinical outcomes, while reducing the costs of care associated with complications as well as variability in protocols. We provide extensive continuing medical education and continuing
nursing education to our affiliated clinicians in an effort to ensure that they have access to current treatment methodologies, national best practices and evidence-based guidelines. We believe that referring and collaborating physicians, hospitals,
third-party payors and patients all benefit from our clinical research, education, quality and safety initiatives. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>DEMAND FOR OUR SERVICES </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Hospital-Based Care. </I></B>Hospitals generally must provide cost-effective, quality care in order to enhance their reputations within
their communities and desirability to patients, referring and collaborating physicians and third-party payors. In an effort to improve outcomes and manage costs, hospitals typically employ or contract with physician specialists to provide
specialized care in many hospital-based units or settings. Hospitals traditionally staff these units or settings through affiliations with local physician groups or independent practitioners. However, management of these units and settings presents
significant operational challenges, including variable admissions rates, increased operating costs, complex reimbursement systems and other administrative burdens. As a result, some hospitals choose to contract with physician organizations that have
the clinical quality initiatives, information and reimbursement systems and management expertise required to effectively and efficiently operate these units and settings in the current healthcare environment. Demand for hospital-based physician
services, including neonatology and anesthesiology, is determined by a national market in which qualified physicians with advanced training compete for hospital contracts. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Neonatal Medicine</I></B><B>.</B> Of the approximately 3.9&nbsp;million births in the United States annually, we estimate that
approximately 14% require NICU admission. Numerous institutions conduct research to identify potential causes </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>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
of premature birth and medical complications that often require NICU admission. Some common contributing factors include the presence of hypertension or diabetes in the mother, lack of prenatal
care, complications during pregnancy, drug and alcohol abuse and smoking or poor nutritional habits during pregnancy. Babies admitted to NICUs typically have an illness or condition that requires the care of a neonatologist. Babies who are born
prematurely or have a low birth weight often require neonatal intensive care services because of an increased risk for medical complications. We believe obstetricians generally prefer to perform deliveries at hospitals that provide a full complement
of labor and delivery services, including a NICU staffed by board-certified, or
<FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">eligible-to-apply-for-certification,</FONT></FONT></FONT></FONT> neonatologists. Because obstetrics is a significant
source of hospital admissions, hospital administrators have responded to these demands by establishing NICUs and contracting with independent neonatology group practices, such as our affiliated professional contractors, to staff and manage these
units. As a result, NICUs within the United States tend to be concentrated in hospitals with higher volumes of births. There are approximately 5,600 board-certified neonatologists in the United States. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Anesthesia Medicine.</I></B><B> </B>An estimated 50&nbsp;million inpatient procedures and 35&nbsp;million ambulatory procedures are
performed annually in the United States. Anesthesiologists generally provide or participate in the administration of anesthetics in these procedures. According to the U.S. Census Bureau, the U.S. population continues to expand and the
fastest-growing segment of the population consists of individuals over the age of 65. The growth in population and, in particular the age 65 or greater segment, has resulted in an increase in demand for surgical services and a correlating increase
in demand for anesthesia services. The growth of ambulatory surgical centers and expansion of office-based procedures has also contributed to the demand for anesthesia providers. There are approximately 51,000 board certified/eligible
anesthesiologists in the United States. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Pain Management. </I></B>According to the American Academy of Pain Medicine, more than
75&nbsp;million people suffer from pain and 15% of those who suffer from pain will consult with a pain specialist. As the population ages, we believe that the number of people suffering from acute or chronic pain will continue to increase. Lifestyle
also plays an important part in the demand for pain management services. We believe that the combination of the growing population of people who suffer from pain, the lifestyle expectations of this population and the ability for patients to seek out
a pain specialist without having to be referred by a physician will increase the demand for pain management services. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Maternal-Fetal Medicine</I></B><B>.</B> Expectant mothers with pregnancy complications often seek or are referred by their obstetricians
to maternal-fetal medicine subspecialists. These subspecialists provide inpatient and office-based care to women with conditions such as diabetes, heart disease, hypertension, multiple gestation, recurrent miscarriage, family history of genetic
diseases, suspected fetal birth defects and other complications during their pregnancies. We believe that improved maternal-fetal care has a positive impact on neonatal outcomes. Data on neonatal outcomes demonstrates that, in general, the
likelihood of mortality or an adverse condition or outcome (referred to as &#147;morbidity&#148;) is reduced the longer a baby remains in the womb. There are approximately 2,500 board-certified maternal-fetal medicine subspecialists in the United
States. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Pediatric Cardiology Medicine</I></B><B>. </B>Pediatric cardiologists provide inpatient and office-based cardiology care of
the fetus, infant, child, and adolescent with congenital heart defects and acquired heart disease, as well as providing care to adults with congenital heart defects. We estimate that approximately one in every 125 babies is born with some form of
heart defect. With advancements in care, there are approximately 1.4&nbsp;million adults in the United States today living with congenital heart disease. There are approximately 2,800 board-certified pediatric cardiologists in the United States.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Other Pediatric Subspecialty Medicine</I></B><B>.</B> Other areas of pediatric subspecialty medicine are closely associated with
maternal-fetal-newborn medical care. For example, pediatric intensivists are subspecialists who care for critically ill or injured children and adolescents in PICUs. There are approximately 2,200 board-certified pediatric intensivists in the United
States. As another example, pediatric hospitalists are pediatricians who provide care in many hospital areas, including labor and delivery and the newborn nursery. In addition, pediatric surgeons provide specialized care for patients ranging from
newborns to adolescents, for all problems or </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">8 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
conditions affecting children that require surgical intervention, and often have particular expertise in the areas of neonatal, prenatal, trauma, and pediatric oncology. There are approximately
1,000 board-certified pediatric surgeons in the United States. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Radiology. </I></B>Radiology is the branch of medical science that
uses a variety of medical imaging technology to diagnose injury and disease and sometimes treat diseases in the body. A variety of imaging techniques such as <FONT STYLE="white-space:nowrap">X-ray,</FONT> fluoroscopy, ultrasound, computed tomography
(CT), nuclear medicine, including positron emission tomography (PET), and magnetic resonance imaging (MRI) are used. Interventional radiology is the performance of typically minimally invasive medical procedures with the guidance of imaging
technologies. According to the U.S. Census Bureau, the U.S. population continues to expand and the fastest-growing segment of the population consists of individuals over the age of 65. The growth in population and, in particular the age 65 or
greater segment, is expected to result in an increase in demand for radiology services as the increased medical needs of this population require more imaging. There are approximately 34,000 board-certified radiologists in the United States. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Teleradiology and Telemedicine</I></B><B>.</B> Teleradiology is the transmission of radiographic images from one location to another for
interpretation. Teleradiology represents a component of the broader radiology industry. Within this market, teleradiology is a fast growing segment of the physician services sector. We believe that there are several factors prompting growth of the
teleradiology model. <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">Around-the-clock</FONT></FONT> subspecialty coverage is becoming a standard of care; the idea that a general radiologist practicing in a single hospital has the
ability to read all types of images is no longer prevalent. On behalf of their patients, healthcare facilities increasingly seek to have diagnostic images evaluated by radiologists who have expertise in specific subspecialty areas such as
neuroradiology, cardiac imaging and vascular surgery. In addition, facilities wish to have this subspecialty service available to them immediately because timing is critical for treatment and recovery. Advances in technology now make this <FONT
STYLE="white-space:nowrap">around-the</FONT> clock expert attention possible; using remote/onsite integration and data analytics, teleradiologists can read diagnostic images from anywhere at any time and seamlessly deliver results. This not only
provides the ability to determine optimal treatment decisions for the patient, but also enhances a healthcare facility&#146;s ability to efficiently and effectively meet its patients&#146; needs. Since most teleradiology work is completed remotely,
the pool of qualified radiologists who are subspecialty trained is significantly greater than would be available in a single geographic area. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Another key driver, we believe, is how we support forward-thinking radiology groups that are attempting to become high-performance providers
in their markets. Traditionally, radiology groups have had to staff to their peak volume creating periods where they are overstaffed as volume ramps up or down. With us as a partner, radiology groups can staff to meet typical demand, as opposed to
overstaffing, and leverage our solutions for additional coverage at all times, not just the overnight hours. Likewise, radiology groups can more quickly expand their services to other geographies and locations with us as a partner reducing or
eliminating the time it takes to recruit physicians for growth. Similarly, teleradiology coverage can be provided for other physician group staffing challenges such as physician retirement and attrition, or to provide expertise in specific
subspecialty areas that may not be covered by the physicians in the practice. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Further, we believe there are broader applications across
the larger telemedicine industry for the use of the proprietary technology and workflow platform utilized within our teleradiology business. Telemedicine services are well documented as high quality, safe and efficient means of expanding physician
services into metropolitan and rural communities. We have begun to expand our services to provide these remote programs to our hospital partners and believe that this will become more relevant as more healthcare providers integrate remote healthcare
solutions into their healthcare practices. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Physician Practice Administration. </I></B>Administrative demands and cost containment
pressures from a number of sources, principally commercial and government payors, make it increasingly difficult for physicians to effectively manage patient care, remain current on the latest procedures and efficiently administer <FONT
STYLE="white-space:nowrap">non-clinical</FONT> activities. As a result, we believe that physicians remain receptive to being affiliated with larger organizations </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>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
that reduce administrative burdens, achieve economies of scale and provide value-added clinical research, education and quality initiatives. By relieving many of the burdens associated with the
management of a subspecialty group practice, we believe that our practice administration services permit our affiliated physicians to focus on providing quality patient care and thereby contribute to improving patient outcomes, ensuring appropriate
length of hospital stays and reducing long-term health system costs. In addition, our national network of affiliated physician practices, modeled around a traditional group practice structure, is managed by a
<FONT STYLE="white-space:nowrap">non-clinical</FONT> professional management team with proven abilities to achieve significant operating efficiencies in providing administrative support systems, interacting with physicians, hospitals and third-party
payors, managing information systems and technologies, and complying with applicable laws, rules and regulations. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><I>Management
Services / Full-Service Revenue Cycle Management. </I></B>Our management services organization is designed to help physicians and other healthcare providers better engage patients throughout the entire healthcare continuum by addressing the various
challenges that they face from the complexity of reimbursement and practice coordination in today&#146;s healthcare environment. We believe our suite of solutions sets our management services organization apart in the world of healthcare revenue
cycle management. Our suite of solutions includes a range of patient access and communications, revenue cycle management, consulting and analytics services, billing and coding, patient responsibility, eligibility and disability, complex accounts
receivable services such as workers&#146; compensation, <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-state</FONT></FONT> Medicaid eligibility and more, as well as offering advanced technology solutions through
mobile-first engagement and communication software for patients and providers. By allowing our organization to step in and handle these areas, hospitals and other healthcare providers can focus on providing care to their patients without the
administrative burdens. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The healthcare landscape is changing rapidly, particularly in various areas that hospitals and other healthcare
providers typically have not invested in. Our solutions become even more relevant in these specific areas. For example, as patient responsibility balances continue to grow and become harder to collect, our management services organization&#146;s
unique process of patient outreach and communication, before the healthcare bills are even sent, is a proven solution to this problem that also enhances patient satisfaction. Our management services organization also helps hospitals and other
healthcare providers streamline the eligibility process for Medicaid. Medicaid eligibility is not a simple process to establish, as it differs across states and must be reestablished monthly, and is a critical function as there are millions of
individuals who are eligible for Medicaid. We believe that our solutions address the key areas where hospitals and other healthcare providers must adapt to the changes in the business of healthcare. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In November 2018, we announced the initiation of a process to potentially divest our management services organization to allow us to focus our
organization on our core physician services business. However, there can be no assurance that this process will result in a transaction, and we may decide to retain all or part of the management services organization. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>OUR BUSINESS STRATEGY </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our business
objective is to enhance our position as a leading provider of physician and other complementary healthcare services. The key elements of our strategy to achieve this objective are: </P>
<P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Build upon core competencies</I></B><I>.</I> We have developed significant administrative expertise
relating to our practice physician services. We have also facilitated the development of a clinical approach to the practice of medicine among our affiliated physicians through clinical data warehouses that include research, education and quality
initiatives intended to advance the practice of medicine and care, improve the quality of care provided to our patients and reduce long-term health system costs. Analysis of the data within our clinical data warehouses across our neonatology,
anesthesia and other pediatric subspecialty services allows us to provide feedback to our physicians and hospital partners and to develop and implement best practices, all with the goal of improving outcomes, creating efficiencies and ensuring
patient satisfaction. As healthcare organizations are expected to increasingly be held accountable for the </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">10 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">
quality and cost of the care they provide, we believe that our ability to capture this data within our clinical data warehouses adds value to our patients and our hospital and physician partners.
</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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Promote same-unit and organic growth</I></B><B>.</B> We seek opportunities for increasing revenue from our
hospital- and office-based operations. For example, our affiliated hospital-based neonatal, maternal-fetal and other pediatric physicians are well situated to, and, in some cases, provide physician services in other departments, such as pediatric
emergency rooms, newborn nurseries, or in situations where immediate accessibility to specialized obstetric and pediatric care may be critical. Our hospital-based and office-based physicians continue to pursue an organic growth strategy that
involves working with our hospital partners to develop integrated service programs for which we become a provider of solutions across the maternal-fetal, newborn, pediatric continuum of care. An integrated program results in a broader offering of
care across our specialties and permits the extension of our service lines in our markets. We have successfully executed this organic growth strategy and market partnership in many metropolitan areas and intend to continue this growth initiative in
the future. In addition, we market our capabilities to obstetricians, pediatricians and family physicians to attract referrals to our hospital-based units and our office-based practices. We also market the services of our affiliated physicians to
other hospitals to attract maternal, neonatal and pediatric transport admissions. In addition, we may pursue new contractual arrangements with hospitals, including possibly through joint ventures, either where we currently provide or do not
currently provide physician services. </P></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have had success developing other programs with our hospital
partners. One of these programs relates to obstetric hospitalists (&#147;OB hospitalists&#148;) whereby we have collaborated with hospitals to design programs for which an OB hospitalist is on site at the hospital on a shift basis to provide care
for laboring patients and managing obstetrical emergencies. We believe this program is valuable to our hospital partners as the program improves patient safety in part by preventing unattended deliveries and allowing for swifter emergency treatment.
An additional benefit from such a program for our hospital partners is that local obstetricians unable to attend deliveries can be confident that there are dedicated <FONT STYLE="white-space:nowrap">in-house</FONT> obstetricians available to attend
such deliveries, and they may therefore choose to deliver at hospitals with such programs. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">We also continue to expand our
services in telemedicine, which is the use of telecommunication and information technology in order to provide clinical healthcare at a distance. Our acquisition of vRad was a significant milestone in this rapidly evolving area of healthcare and
provided us with vRad&#146;s proprietary technology and workflow platform. Similarly, we expect that many pediatric subspecialties as well as maternal-fetal medicine, will benefit in the future from having a robust platform in telemedicine.
Telemedicine services are well documented as high quality, safe and efficient means of expanding physician services into metropolitan and rural communities. We have expanded our services to provide these remote programs to our hospital partners.
These programs enhance the standing of our hospital partners while creating another portal of entry of pediatric patients to our inpatient service lines. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">Additionally, with the goal of further expanding our organic growth strategy, our national sales team pursues opportunities
across our service lines by employing a targeting strategy with a specific focus and prioritization. This sales team works with existing hospital and other healthcare partners and also focuses on building new relationships with hospitals and other
service providers to which we do not currently provide services in order to offer clinical and other solutions and respond to requests for proposals. Our growth teams are managed under one collaborative group that addresses acquisition and organic
growth opportunities with the shared goal of MEDNAX being viewed by hospitals and other partners as a multi-specialty health solutions partner across all of its service lines. </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>

<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Acquire physician practice groups. </I></B>We continue to seek to expand our operations by acquiring
established physician practices in our core physician specialties and pursuing complementary pediatric subspecialty physician groups outside of our core specialties when appropriate. During 2018, we added nine physician group practices, including
five radiology practices, two neonatology practices, and two </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">11 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">
other pediatric subspecialty practices. We currently expect a modest level of acquisition activity during 2019 and intend to primarily focus that acquisition activity in our radiology,
neonatology and other pediatric subspecialty service lines. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Strengthen and broaden relationships with our partners</I></B><B>.</B> By managing many of the operational
challenges associated with physician practices, encouraging clinical research, education and quality initiatives, and promoting timely intervention by our physicians, we believe that our business model is focused on improving the quality of care
delivered to patients, promoting the appropriate length of their hospital stays and optimizing efficient use of health system resources. We believe that referring and collaborating physicians, hospitals, third-party payors and patients all benefit
to the extent that we are successful in implementing our business model. In addition, we will continue to concentrate efforts in becoming more responsive and proactive in broadening our existing hospital relationships to expand the scope of services
that we provide across all specialties. We believe this will be critical as hospitals and health systems seek to expand their service offerings and as the broader healthcare market seeks new solutions to operate more efficiently.
</P></TD></TR></TABLE> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Focus on Shared Services and Operational Initiatives</I></B>. We have developed a number of strategic
initiatives across our organization, in both our shared services functions and our operational infrastructure, with a goal of generating improvements in our general and administrative expenses and our operational infrastructure. In our shared
services departments, we are focused on improving processes, using our resources more efficiently and utilizing our scale more effectively to improve cost and service performance across 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 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></TD></TR></TABLE> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>CLINICAL RESEARCH,
EDUCATION, QUALITY AND SAFETY </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As part of our patient focus and ongoing commitment to improving patient care through evidenced-based
medicine, we engage in clinical research, continuous quality improvement, safety and education initiatives. We discover, understand and teach healthcare practices that enhance the abilities of clinicians to deliver quality care, thereby contributing
to better patient outcomes and reduced long-term health system costs. Our investment in these initiatives benefits our patients, clinicians, referring and collaborating physicians, hospital partners and third-party payors. We believe that these
initiatives help us, among other things, to enhance the value of our services, attract new and retain existing clinicians, improve clinical operations and enhance practice communication. </P>
<P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Clinical Research.</I></B> We conduct clinical research to discover ways to improve clinical care for our
patients and share our discoveries throughout the medical community through submissions to peer-reviewed literature. To help facilitate and support research efforts, MEDNAX established a Research Advisory Committee (RAC). The goal of the RAC is to
design, implement and maintain a program for clinical research oversight and support that enables our practices to conduct research that is safe, effective, financially viable and legally compliant, while optimizing research opportunities. The
RAC&#146;s multi-disciplinary approach involves the collaboration of both clinical and business professionals, including finance, legal and compliance, and has ultimately enhanced our research efforts and improved overall process flow. With
participating clinicians located throughout the country, the RAC supports a comprehensive scope of research efforts, allowing for a more <FONT STYLE="white-space:nowrap">in-depth</FONT> look at our specialties. This nationwide perspective allows us
to better anticipate future needs and opportunities. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Quality and Safety. </I></B>Through the leadership of our affiliated clinicians, we have cultivated a
culture of continuous quality improvement and safety, which is the cornerstone of our success and helps us to </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">12 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">
fulfill our mission. Our team of clinical experts leads and provides oversight for several national quality and safety programs across various specialties and subspecialties.
</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="9%">&nbsp;</TD>
<TD WIDTH="3%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Continuous Quality Improvement (&#147;CQI&#148;)</I></B><I>.</I> CQI initiatives are important for all of
our physician specialties. As part of our dedication to improving quality across our affiliated practices, we provide our clinicians with the opportunity to collaborate and share best practices and facilitate access to valuable information,
resources and professional development tools. From these collaborations, our affiliated physicians can identify areas for improvement, and then systematically monitor, study, learn, and implement change. There are several complex initiatives that
are derived and based on our long-standing CQI efforts, such as our Regional Resource Teams, our National High Reliability Organization (&#147;HRO&#148;) program and our Performance Improvement Teams. For anesthesia care, we have launched a new
Comprehensive Enhanced Recovery after Surgery program and continue to offer a Centers for Medicare and Medicaid Service (&#147;CMS&#148;) certified Qualified Clinical Data Registry (&#147;QCDR&#148;). Our quality metrics are analyzed to include
standard clinical outcome reporting, trend analysis and threshold performance, all of which are provided to our individual physicians. The quality committees and medical directors of the practices manage quality improvement programs and drive best
practices that are adapted to the needs of the local care setting. </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="9%">&nbsp;</TD>
<TD WIDTH="3%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Patient Safety Organization (&#147;PSO&#148;). </I></B>We have established a federally listed PSO, the
mission of which is to improve the quality and safety of care rendered by our clinical providers through the collection and analysis of quality data. As a federally listed PSO, our mission to improve the safety of care rendered is supported by the
dissemination of best practices information and implementation of patient safety programs. Both our anesthesiology HRO program and women&#146;s and children&#146;s HRO program aim to provide &#147;Just Culture&#148; training to our clinicians. The
complex curriculum has been customized to meet our affiliated physician practices&#146; needs and is based on principles outlined by the Agency for Healthcare Research and Quality (&#147;AHRQ&#148;), Institute for Healthcare Improvement, National
Patient Safety Foundation and Team STEPPS, the teamwork system developed by the AHRQ and the Department of Defense. </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="9%">&nbsp;</TD>
<TD WIDTH="3%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Simulation.</I></B> Practicing critical decision-making, communication, task and teamwork skills
with<I>&nbsp;in situ</I>&nbsp;scenarios promotes optimized clinical performance for high-risk, <FONT STYLE="white-space:nowrap">low-volume</FONT> critical situations. To meet the needs of our health care providers, hospital and ASC partners, as well
as our patients, MEDNAX offers a variety of customized simulation programs with the aim of instilling competence and confidence with one goal in mind: improved outcomes. Our Simulation Program has gained provisional accreditation by the Society
for&nbsp;Simulation in&nbsp;Healthcare, a required first step towards attaining full accreditation, and currently offers highly interactive programs for neonatology, anesthesiology and hospital-based medicine practices. The effects of simulation are
proven as a performance improvement method and are known to lead to enhanced communication and improved patient outcomes. </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="1%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Education. </I></B>Our commitment to clinical and research excellence is evidenced by our comprehensive
educational and professional development opportunities offered. We provide extensive continuing medical education and continuing nursing education to our affiliated clinicians in an effort to ensure that they have access to current treatment
methodologies, national best practices and evidence-based guidelines. As an Accreditation Council for Continuing Medical Education accredited provider, we offer a variety of live and online educational credit opportunities that can be accessed on
demand by our providers and are in synergy with latest research publications and healthcare industry standards. We strive to expand our learning materials to new subspecialties. In addition, each year, thousands of healthcare providers worldwide
take advantage of educational programs hosted by MEDNAX. We believe that the number of clinicians both nationally and internationally who participate in these activities is evidence of the depth and breadth of our clinical expertise and position as
an industry leader. </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="1%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Innovation. </I></B>We believe collaborative innovation is a pathway towards excellence in research,
education, quality and safety. Because of the critical role innovation plays, our team strives to integrate the latest </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">13 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">
technological advances, artificial or augmented intelligence, genetic discoveries and mobile applications into every day care. Tele- and mobile health, virtual reality, next generation
sequencing, <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">point-of-care</FONT></FONT> diagnostics and advanced data analytics are currently shaping the future of medicine. Our team is actively engaged in designing projects that
we believe will allow us to prevent disease, offer precision care and further optimize patient outcomes. </P></TD></TR></TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We believe
that these initiatives have been enhanced by our integrated national presence together with our clinical and management information systems, which are an integral component of our clinical research and education activities. See &#147;Our Information
Systems.&#148; </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>OUR INFORMATION SYSTEMS </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We maintain several information systems that support our
<FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">day-to-day</FONT></FONT> operations, ongoing clinical initiatives and business analysis. </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>BabySteps</I></B><B><I><SUP STYLE="font-size:85%; vertical-align:top">&reg;</SUP></I></B><B><I>.
</I></B>BabySteps is a clinical electronic documentation system used by our affiliated neonatal physicians and other clinicians to record clinical progress notes and certain laboratory and radiology reports and provides a decision tree to assist
them in certain situations with the selection of appropriate billing codes. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Clinical Data Warehouse. </I></B>BabySteps enables our affiliated practices to capture a consistent set of
clinical information about the patients we treat. We <FONT STYLE="white-space:nowrap">de-identify</FONT> and transfer information from our electronic health records that reside in BabySteps to our &#147;clinical data warehouse&#148; that since
inception has accumulated clinical information on more than 1.4&nbsp;million patients and 25&nbsp;million patient days. With comprehensive reporting tools, our physicians are able to use this information to benchmark outcomes, enhance clinical
decision-making and advance best practices at the bedside. Using a variety of clinical performance markers, our <FONT STYLE="white-space:nowrap">de-identified</FONT> data warehouse also helps us track medication and procedure interactions, link
treatments to outcomes and identify opportunities to enhance patient outcomes. Our clinical data warehouse also helps us to identify which prospective clinical trials are most important and allows us to monitor the impact of our continuous quality
improvement initiatives. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B>MEDNAX Qualified Clinical Data Registry (&#147;QCDR&#148;).</B>&nbsp;MEDNAX QCDR is a quality metric
acquisition and database that has been implemented in our anesthesiology, interventional pain and radiology physician practices. QCDR collects patient level data which is then stored, analyzed and reported to physicians and to CMS to address
Merit-Based Incentive Payment System (&#147;MIPS&#148;) requirements within the CMS Quality Payment Program. Our affiliated clinicians use the data, along with evidence-based medicine, to develop and implement best practices and standard operating
procedures, for educational programs and for providing quality metrics, all with the goal of improving outcomes and efficiency and ensuring patient satisfaction. CMS has certified the MEDNAX QCDR as an appropriate platform for reporting under MIPS,
and CMS approved our self-nomination for the 2019 MIPS reporting year. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Nextgen</I></B><B><I><SUP STYLE="font-size:85%; vertical-align:top">&reg;</SUP></I></B><B>.</B> We have
licensed the Nextgen Electronic Medical Record (&#147;EMR&#148;) and Electronic Patient Management (&#147;EPM&#148;) system for our affiliated office-based physicians and other clinicians to record clinical documentation related to their patients
and to manage the revenue cycle for our office-based practices. This system has the ability to provide benefits to our office-based practices that are similar to what BabySteps provides to our neonatology practices, including decision trees to
assist physicians with the selection of compliant billing codes, promotion of consistent documentation, and data for research and education. We are continuing the process of implementing EMR and EPM throughout our office-based practices.
</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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>eCCAP.</I></B> Our electronic charge capture system is used to appropriately record and bill for pediatric
intensive care clinicians, hospitalist clinicians and other clinical care providers. We also use administrative data derived from this system to drive quality assurance and quality improvement programs. </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">14 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Radiology Clinical Data Warehouse. </I></B>Our extensive database of aggregated and normalized radiology
studies powers our sophisticated analytics capabilities. Our analytics technology provides evidence-based insights to our own practice and to key decision makers at hospitals and healthcare systems, as well as to onsite radiology groups regarding
optimal staffing, imaging utilization and clinical outcomes, all to help them more efficiently manage their radiology service lines and practices. Our analytics tools are relevant for both hospitals trying to better manage costs and improve
operating efficiencies, as well as to radiology groups trying to demonstrate value in an increasingly challenging and evolving healthcare reimbursement environment. Our analytics tools differentiate us as a strategic partner to both existing and new
clients who rely on our insight to efficiently manage their radiology service lines and practices. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>MEDNAX Learning
Center</I></B><B><I><SUP STYLE="font-size:85%; vertical-align:top">&reg;</SUP></I></B><B><I>. </I></B>In addition to providing continuing education, our <FONT STYLE="white-space:nowrap">web-based</FONT> education platforms also function as important
educational adjuncts to our affiliated physician groups, providing a rich source of ongoing medical education for our physicians and enabling physicians to discuss cases with one another through various clinical resources. </P></TD></TR></TABLE>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our management information systems are also an integral element of the billing and reimbursement process. We maintain systems that provide for
electronic data interchange with payors that accept electronic submissions, including electronic claims submission, insurance benefits verification and claims processing and remittance advice, which enable us to track numerous and diverse
third-party payor relationships and payment methods. Our information systems provide scalability and flexibility as payor groups upgrade their payment and reimbursement systems. We continually seek improvements to our systems to expedite the overall
process, streamline information gathering from our clinical systems and improve efficiencies in the reimbursement process. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We maintain
additional information systems designed to improve operating efficiencies of our affiliated practice groups, reduce physicians&#146; paperwork requirements and facilitate interaction among our affiliated physicians and their colleagues regarding
patient care issues. Following the acquisition of a physician practice group, we implement systematic procedures to improve the acquired group&#146;s operating and financial performance. One of our first steps is to convert a newly acquired group to
our broad-based management information system. We also maintain a database management system to assist our business development and recruiting departments to identify potential practice group acquisitions and physician candidates. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>PHYSICIAN PRACTICE GROUP ADMINISTRATION </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We provide multiple administrative services to support the practice of medicine by our affiliated physicians and strive to improve operating
efficiencies of our affiliated practice groups. </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Unit Management</I></B>. A senior physician practicing medicine in each physician specialty or subspecialty
practice that we manage acts as the medical director for that practice. Each medical director is responsible for the overall management of his or her practice, including staffing and scheduling, quality of care, professional discipline, utilization
review, coordinating physician recruitment and monitoring of the financial success within the practice. Medical directors also serve as a liaison with hospital administration, other physicians and the community. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Staffing and Scheduling</I></B>. We assist with staffing and scheduling physicians and advanced practice
nurses within the units and practices that we manage. For example, each NICU is staffed by at least one specialist on site or available on call. For our affiliated anesthesia physicians, CRNAs and AAs, we employ an operational system that assists
with their staffing and scheduling. We are responsible for managing and coordinating the process for the salaries and benefits paid and provided to our affiliated physicians and practitioners. In addition, we employ, compensate and manage all <FONT
STYLE="white-space:nowrap">non-medical</FONT> personnel for our affiliated physician groups. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Recruiting and Credentialing</I></B>. We have significant experience in locating, qualifying, recruiting
and retaining experienced physicians. We maintain an extensive nationwide database of neonatologists, </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">15 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">
maternal-fetal medicine physicians, anesthesiologists and other pediatric subspecialty physicians and are working to develop such a database for radiologists. Our medical directors and physician
leaders play a central role in the recruiting and interviewing process before candidates are introduced to other practice group physicians and hospital administrators. We verify the credentials, licenses and references of all prospective affiliated
physician candidates. In addition to our database of physicians, we recruit nationally through trade advertising, referrals from our affiliated physicians and attendance at conferences. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Billing, Collection and Reimbursement</I></B>. We assume responsibility for assisting our affiliated
physicians with contracting with third-party payors. We are responsible for billing, collection and reimbursement for services rendered by our affiliated physicians. In all instances, however, we do not assume responsibility for charges relating to
services provided by hospitals or other physicians with whom we collaborate. Such charges are separately billed and collected by the hospitals or other physicians. We provide our affiliated physicians and other clinicians with a training curriculum
that emphasizes detailed documentation of and compliant coding protocols for all procedures performed and services provided, and we provide comprehensive internal auditing processes, all of which are designed to achieve compliant coding, billing and
collection of revenue for physician services. Generally, our billing and collection operations are conducted from our business offices located across the United States and in Puerto Rico, as well as our corporate offices. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Risk Management</I></B>.<B> </B>We maintain a risk management program focused on reducing risk, including
the identification and communication of potential risk areas to our medical affairs staff. We maintain professional liability coverage for our national group of affiliated healthcare professionals. Through our risk management and medical affairs
staff, we conduct risk management programs for loss prevention and early intervention in order to prevent or minimize professional liability claims. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Compliance</I></B>. We provide a multi-faceted compliance program that is designed to assist our affiliated
practice groups in understanding and complying with the increasingly complex laws, rules and regulations that govern the provision of healthcare services. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt"><B><I>Other Services</I></B>. We also provide management information systems, facilities management, legal
support, marketing support and other services to our affiliated physicians and affiliated practice groups. </P></TD></TR></TABLE> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>RELATIONSHIPS WITH OUR
PARTNERS </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our business model, which has been influenced by the direct contact and daily interaction that our affiliated physicians have
with their patients, emphasizes a patient-focused clinical approach that addresses the needs of our various &#147;partners,&#148; including hospitals, third-party payors, referring and collaborating physicians, affiliated physicians and, most
importantly, our patients. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Hospitals and Other Customers </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our relationships with our hospital partners and other customers are critical to our operations. Hospitals control access to their units and
operating rooms through the awarding of contracts and hospital privileges. We have been retained by approximately 570 hospitals to staff and manage clinical activities within specific hospital-based units and other departments. Our affiliated
physicians are important components of obstetric, pediatric and surgical services provided at hospitals. Our hospital-based focus enhances our relationships with hospitals and creates opportunities for our affiliated physicians to provide patient
care in other areas of the hospital. For example, our physicians may provide care in emergency rooms, nurseries, intensive care units and other departments where access to specialized obstetric, pediatric and anesthesia care may be critical. Our
hospital partners benefit from our expertise in managing critical care units and other settings staffed with physician specialists, including managing variable admission rates, operating costs, complex reimbursement systems and other administrative
burdens. We work with our hospital partners to enhance their reputation and market our services to referring physicians within the communities served by those hospitals. We also provide radiology </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>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
physician services to hospitals and other physician groups. In addition, our affiliated physicians work with our hospital partners to develop integrated services programs for solutions within the
services we provide. Integrated programs provide our hospital partners and us with incremental growth and result in a broader spectrum of care across our specialties and permit us to extend our patient service lines into our existing markets. Our
relationships with our hospital partners are continually evolving with the goal of being viewed by them as a solutions provider across all of our specialties. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Under our contracts with hospitals, we have the responsibility to manage, in many cases exclusively, the provision of physician services for
hospital-based units, such as NICUs, and other hospital settings. We typically are responsible for billing patients and third-party payors for services rendered by our affiliated physicians separately from other related charges billed by the
hospital or other physicians to the same payors. Some of our hospital contracts require hospitals to pay us administrative fees. Some contracts provide for fees if the hospital does not generate sufficient patient volume in order to guarantee that
we receive a specified minimum revenue level. We also receive fees from hospitals for administrative services performed by our affiliated physicians providing medical director services at the hospital. Administrative fees accounted for 10% of our
net revenue during 2018. Some of our contracts with hospitals require us to indemnify them and their affiliates for losses resulting from the negligence of our affiliated physicians. Our hospital contracts typically have terms of one to three years
which can be terminated without cause by either party upon prior written notice, and renew automatically for additional terms of one to three years unless terminated early by any party. While we have in most cases been able to renew these
arrangements, hospitals may cancel or not renew our arrangements, or reduce or eliminate our administrative fees in the future. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Third-Party Payors
</B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our relationships with government-sponsored or funded healthcare programs (&#147;GHC Programs&#148;), including Medicare and Medicaid,
and with managed care organizations and commercial health insurance payors are vital to our business. We seek to maintain professional working relationships with our third-party payors, streamline the administrative process of billing and
collection, and assist our patients and their families in understanding their health insurance coverage and any balances due for <FONT STYLE="white-space:nowrap">co-payments,</FONT> <FONT STYLE="white-space:nowrap">co-insurance,</FONT> deductibles
or benefit limitations. In addition, through our quality initiatives and continuing research and education efforts, we have sought to enhance clinical care provided to patients, which we believe benefits third-party payors by contributing to
improved patient outcomes and reduced long-term health system costs. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We receive compensation for professional services provided by our
affiliated physicians to patients based upon rates for specific services provided, principally from third-party payors. Our billed charges are substantially the same for all parties in a particular geographic area, regardless of the party
responsible for paying the bill for our services, but the payments we receive vary among payors. A significant portion of our net revenue is received from GHC Programs, principally state Medicaid and federal Medicare programs. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Medicaid programs, which are jointly funded by the federal government and state governments, pay for medical and health-related services for
certain categories of individuals and families generally who have low incomes or disabilities. Medicaid programs can be either standard <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> payment programs
or managed care programs in which states have contracted with health insurance companies to run local or state-wide health plans with features similar to health maintenance organizations. Our compensation rates under standard <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> Medicaid programs are established by state governments and are not negotiated. Although Medicaid rates vary across the states, these rates are generally much
lower in comparison to private-sector health plan rates. Rates under Medicaid managed care programs typically are negotiated, but are also much lower in comparison to private-sector health plan rates. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Affordable Care Act (&#147;ACA&#148;) allows states to expand their Medicaid programs to enroll more individuals through federal payments
that fund most of the cost of increasing the Medicaid eligibility income limit from a state&#146;s historical eligibility levels to 133% of the federal poverty level. To date, 36 states and the </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">17 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
District of Columbia have expanded Medicaid eligibility to cover this additional low income patient population (including states that have adopted but not yet implemented expansion and those that
are using an alternative approach to eligibility expansion) and other states are considering such expansion. All of the states in which we operate, however, already cover children in the first year of life and pregnant women if their household
income is at or below 133% of the federal poverty level. In light of changes to the ACA, some of these states may eliminate, reduce or otherwise modify expanded enrollment eligibility. See Item 1A. Risk Factors &#151; &#147;State budgetary
constraints and the uncertainty over the future Medicaid expansion could have an adverse effect on our reimbursement from Medicaid programs&#148; and &#147;The ACA and potential changes to it may have a significant effect on our business.&#148; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Medicare is a health insurance program primarily for individuals 65 years of age and older, younger individuals with certain disabilities and
individuals with <FONT STYLE="white-space:nowrap">end-stage</FONT> renal disease. The program is available without regard to income or assets (with means-tested premiums for beneficiaries with relatively high incomes) and offers beneficiaries
different ways to obtain their medical benefits. The most common option selected today by Medicare beneficiaries is the traditional <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> payment system. The
other options include managed care, preferred provider organizations, private <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> and specialty plans. Medicare compensation rates are generally much lower
in comparison to private-sector health plans. Because we provide services to a wide array of patients, including Medicare beneficiaries, a portion of our patients&#146; services are reimbursed by Medicare. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In order to participate in government programs, we and our affiliated practices must comply with stringent and often complex standards,
including enrollment and reimbursement requirements. Different states also impose varying standards for their Medicaid programs. See &#147;Government Regulation&#151;Government Regulatory Requirements.&#148; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We also receive compensation pursuant to contracts with commercial payors that offer a wide variety of health insurance products, such as
health maintenance organizations, preferred provider organizations and exclusive provider organizations that are subject to various state laws and regulations, as well as employer-sponsored coverage subject to federal Employee Retirement Income
Security Act (&#147;ERISA&#148;) requirements. We seek to secure mutually agreeable contracts with payors that enable our affiliated physicians to be listed as <FONT STYLE="white-space:nowrap">in-network</FONT> participants within the payors&#146;
provider networks. We generally contract with commercial payors through our affiliated professional contractors. Subject to applicable laws, rules and regulations, the terms, conditions and compensation rates of our contracts with commercial
third-party payors are negotiated and often vary across markets and among payors. In some cases, we contract with organizations that establish and maintain provider networks and then rent or lease such networks to the actual payor. Our contracts
with commercial payors typically provide for discounted <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> arrangements and grant each party the right to terminate the contracts without cause upon prior
written notice. In addition, these contracts generally give commercial payors the right to audit our billings and related reimbursements for professional and other services provided by or through our affiliated physicians. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">If we do not have a contractual relationship with a health insurance payor, we generally bill the payor our full billed charges. If payment is
less than billed charges, we bill the balance to the patient, subject to federal and state laws regulating such billing. Although we maintain standard billing and collections procedures with appropriate discounts for prompt payment, we also provide
discounts in certain hardship situations where patients and their families do not have financial resources necessary to pay the amount due for services rendered. Any amounts <FONT STYLE="white-space:nowrap">written-off</FONT> are based on the
specific facts and circumstances related to each individual patient account. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Referring and Collaborating Physicians </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our relationships with our referring and collaborating physicians are critical to our success. Our affiliated physicians seek to establish and
maintain professional relationships with referring physicians in the communities </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>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
where they practice. Because patient volumes in our NICUs are based in part on referrals from other physicians, particularly obstetricians, it is important that we are responsive to the needs of
referring physicians in the communities in which we operate. We believe that our community presence, through our hospital coverage and outpatient clinics, assists referring obstetricians, office-based pediatricians and family physicians with their
practices. Our affiliated physicians are able to provide comprehensive maternal-fetal, newborn and pediatric subspecialty care to patients using the latest advances in methodologies, supporting the local referring physician community with <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">24-hours-a-day,</FONT></FONT></FONT> <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">seven-days-a-week</FONT></FONT> <FONT
STYLE="white-space:nowrap">on-site</FONT> or <FONT STYLE="white-space:nowrap">on-call</FONT> coverage. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our affiliated anesthesiologists
seek to establish and maintain professional relationships with collaborating physicians, such as surgeons, and other healthcare providers. Our affiliated anesthesiologists play an important role for surgeons because they provide medical care to the
patient throughout the surgical experience. This care includes evaluation of the patient prior to surgery, consultations with the surgical team, providing pain control and support of life functions during surgery and supervising care following
surgery through the discharge of the patient from the recovery unit. Accordingly, our affiliated anesthesiologists are focused on delivering quality services to enhance the reputation and satisfaction of collaborating surgeons. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Affiliated Physicians and Practice Groups </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our relationships with our affiliated physicians are important. Our affiliated physicians are organized in traditional practice group
structures. In accordance with applicable state laws, our affiliated practice groups are responsible for the provision of medical care to patients. Our affiliated practice groups are separate legal entities organized under state law as business
corporations or professional associations, professional corporations, limited liability companies and partnerships, which we sometimes refer to as our &#147;affiliated professional contractors&#148;. Each of our affiliated professional contractors
is owned by a licensed physician affiliated with the Company through employment or another contractual relationship. Our national infrastructure enables more effective and efficient sharing of new discoveries and clinical outcomes data, including
best demonstrated processes, access to our sophisticated information systems, clinical research and education. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our business corporations
and affiliated professional contractors employ or contract with physicians to provide clinical services in certain states and Puerto Rico. In most of our affiliated practice groups, each physician has entered into an employment agreement with us or
one of our affiliated professional contractors providing for a base salary and incentive bonus eligibility and typically having a term of three to seven years. We are typically responsible for billing patients and third-party payors for services
rendered by our affiliated physicians and, with respect to services provided in a hospital, separately from other charges billed by hospitals to the same payors. Each physician must hold a valid license to practice medicine in the state in which he
or she provides patient care and must become a member of the medical staff, with appropriate clinical privileges, at each hospital at which he or she practices. Substantially all the physicians employed by us or our affiliated professional
contractors have agreed not to compete within a specified geographic area during employment and for a certain period after termination of employment. Although we believe that the <FONT STYLE="white-space:nowrap">non-competition</FONT> covenants of
our affiliated physicians are reasonable in scope and duration and therefore enforceable under applicable state laws, we cannot predict whether a court or arbitration panel would enforce these covenants in any particular case. Our hospital contracts
also typically require that we and the physicians performing services maintain minimum levels of professional and general liability insurance. We negotiate those policies and contract and pay the premiums for such insurance on behalf of the
physicians. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of our affiliated professional contractors has entered into a comprehensive management agreement with a subsidiary of
MEDNAX as the manager. Under the terms of these management agreements, and subject to state laws and other regulations, the manager is typically paid for its services based on the performance of the applicable practice group. See &#147;Government
Regulation&#151;Fee Splitting; Corporate Practice of Medicine.&#148; </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>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>COMPETITION </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The physician services industry is highly fragmented. Competition in our business is generally based upon a number of factors, including
reputation, experience and level of care and our affiliated physicians&#146; ability to provide cost-effective, quality clinical care. The nature of competition for our hospital-based practices, such as neonatology, anesthesiology and radiology,
differs significantly from competition for our office-based practices. Our hospital-based practices compete nationally with other health services companies and physician groups for hospital contracts and qualified physicians. In some instances, our
hospital-based physicians also compete on a regional or local basis. For example, our neonatologists compete for referrals from local physicians and transports from surrounding hospitals. Our office-based practices, such as maternal-fetal medicine
and pediatric cardiology, compete for patients with office-based practices in those subspecialties. In addition, we compete in our teleradiology service line with other teleradiology service providers where costs to provide services may be lower and
turnaround times may be faster. We also compete directly with hospitals themselves as they may consider reading images with their own employed radiologists rather than outsource those reads to our affiliated radiologists. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Hospitals control access to their NICUs and operating rooms by awarding contracts and hospital clinical privileges, and our relationships with
our hospital partners are critical to our operations. Because our operations consist primarily of physician services provided within hospital-based units, we compete with others for contracts with hospitals to provide services. We also compete with
hospitals themselves to provide such services. Hospitals may employ neonatologists, anesthesiologists or radiologists directly or contract with other physician groups to provide services either on an exclusive or
<FONT STYLE="white-space:nowrap">non-exclusive</FONT> basis. A hospital not otherwise competing with us may begin to do so by opening a new NICU or operating facility, expanding the capacity of an existing NICU, adding operating room suites or, in
the case of neonatal services, upgrading the level of its existing NICU. If the hospital chooses to do so, it may award the contract to operate the relevant facility to a competing group or company from within or outside the surrounding community.
Our contracts with hospitals generally provide that they may be terminated without cause upon prior written notice. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The healthcare
industry is highly competitive. Companies in other segments of the industry as well as healthcare-focused and other private equity firms, some of which have financial and other resources greater than ours, may become competitors in providing
neonatal, anesthesia, radiology and teleradiology, maternal-fetal and other pediatric subspecialty care. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>GOVERNMENT REGULATION </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The healthcare industry is governed by a framework of federal and state laws, rules and regulations that are extensive and complex and for
which, in many cases, the industry has the benefit of only limited judicial and regulatory interpretation. The resources and costs required to comply with these laws, rules and regulations are high. If we or one of our affiliated practice groups or
service businesses is found to have violated these laws, rules or regulations, our business, financial condition and results of operations could be materially, adversely affected. The ACA made numerous changes that have reshaped the United States
healthcare delivery system. Further healthcare reform, including potential repeal of or changes to the ACA, continues to attract significant legislative and administrative interest, legal challenges, regulatory and compliance requirements, new
approaches and public attention that create uncertainty and the potential for additional changes. Healthcare reform implementation, additional legislation or regulations, and other changes in government policy or regulation may affect our
reimbursement, restrict our existing operations, limit the expansion of our business or impose additional compliance requirements and costs, any of which could have a material adverse effect on our business, financial condition, results of
operations, cash flows and the trading price of our securities. See Item 1A. Risk Factors &#151; &#147;The ACA and potential changes to it may have a significant effect on our business.&#148; </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Licensing and Certification </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each state
imposes licensing requirements on individual physicians and clinical professionals, and on facilities operated or utilized by healthcare companies like us. Many states require regulatory approval, including
</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>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
certificates of need, before establishing certain types of healthcare facilities, offering certain services or expending amounts in excess of statutory thresholds for healthcare equipment,
facilities or programs. We and our affiliated physicians are also required to meet applicable Medicare provider requirements under federal laws, rules and regulations and Medicaid provider requirements under federal and state laws, rules and
regulations. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Fee Splitting; Corporate Practice of Medicine </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Many states have laws that prohibit business corporations, such as MEDNAX, from practicing medicine, employing physicians to practice medicine,
exercising control over medical decisions by physicians, or engaging in certain arrangements, such as fee splitting, with physicians. In light of these restrictions, we operate by maintaining long-term management contracts through our subsidiaries
with affiliated professional contractors, which employ or contract with physicians to provide physician professional services. Under these arrangements, our manager subsidiaries perform only <FONT STYLE="white-space:nowrap">non-medical</FONT>
administrative services, do not represent that they offer medical services and do not exercise influence or control over the practice of medicine by the physicians employed by the affiliated professional contractors. In states where fee splitting
with a business corporation or manager is prohibited, the fees that are received from the affiliated professional contractors have been established on a basis that we believe complies with applicable laws. Although the relevant laws in these states
have been subject to limited judicial and regulatory interpretation, we believe that we are in compliance with applicable state laws in relation to the corporate practice of medicine and fee splitting. However, regulatory authorities or other
parties, including our affiliated physicians, may assert that, despite these arrangements, we or our manager subsidiaries are engaged in the corporate practice of medicine or that the contractual arrangements with the affiliated professional
contractors constitute unlawful fee splitting, in which case we or our affiliated physicians could be subject to administrative, civil or criminal remedies or penalties, the contracts could be found to be legally invalid and unenforceable, in whole
or in part, or we could be required to restructure our contractual arrangements with our affiliated professional contractors. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Fraud and Abuse
Provisions </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Existing federal laws, as well as similar state laws, governing Medicare, Medicaid, other GHC Programs and other <FONT
STYLE="white-space:nowrap">non-governmental</FONT> arrangements and interactions, impose a variety of fraud and abuse prohibitions on healthcare companies like us. These laws are interpreted broadly and enforced aggressively by multiple government
agencies, including the Office of Inspector General of the Department of Health and Human Services, the Department of Justice (&#147;DOJ&#148;) and various state agencies. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Federal and state fraud and abuse laws apply to and affect our financial relationships and other ordinary and common business interactions
with hospitals, referring physicians and other healthcare entities. In particular, the federal anti-kickback statute makes it a crime to knowingly and willfully solicit, receive, offer, or pay any remuneration, in cash or in kind, in return for
either referring items or services for which payment may be made in whole or in part by a GHC Program or purchasing, leasing, ordering, or arranging for or recommending the purchase, lease, or ordering of any service or item for which payment may be
made in whole or in part by a GHC Program. In addition, the federal physician self-referral law, commonly known as the &#147;Stark Law,&#148; is a strict liability statute that prohibits a physician from making a referral to an entity for certain
&#147;designated health services&#148; if the physician, or an immediate family member, has a financial relationship with that entity, unless an exception applies. The entity is prohibited from billing the Medicare program for designated health
services furnished pursuant to a prohibited referral. These laws have been broadly interpreted by federal courts and agencies, and potentially subject many healthcare business arrangements to government investigation, enforcement and prosecution,
which can be costly and time consuming. Many of the states in which we operate also have similar anti-kickback and self-referral laws that apply to our government and <FONT STYLE="white-space:nowrap">non-government</FONT> business. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Violations of these laws are punishable by substantial penalties and other remedies, including monetary fines, civil penalties, administrative
remedies, criminal sanctions (in the case of the anti-kickback statute), exclusion from participation in GHC Programs and forfeiture of amounts collected in violation of such laws. </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>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">There are a variety of other types of federal and state fraud and abuse laws, including laws
authorizing the imposition of criminal, civil and administrative penalties for submitting false or fraudulent claims for reimbursement to GHC Programs. These laws include the federal civil False Claims Act (&#147;FCA&#148;), which prohibits
knowingly presenting, or causing to be presented, false claims to GHC Programs, including Medicare, Medicaid, TRICARE (the program for military dependents and retirees), the Federal Employees Health Benefits Program, and insurance plans purchased
through the ACA insurance exchanges where payments include federal funds. Substantial civil fines and treble damages, along with other remedies, including exclusion from GHC Programs, can be imposed for violating the FCA. Furthermore, the FCA does
not require that the individual or company that presented or caused to be presented an allegedly false claim have actual knowledge of its falsity. The statute applies where the individual or company acted in &#147;reckless disregard&#148; or in
&#147;deliberate ignorance&#148; of the truth or falsity of the claim. The FCA also applies to the improper retention of identified overpayments and includes &#147;whistleblower&#148; provisions that permit private citizens to sue a claimant on
behalf of the government and share in the amounts recovered under the law. In recent years, many cases have been brought against healthcare companies by the government and by &#147;whistleblowers,&#148; which have resulted in judgments and
settlements involving substantial payments to the government by the companies involved. The cost to defend against allegations can also be substantial. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, the Civil Monetary Penalties Law imposes substantial civil monetary penalties against a person or entity that engages in other
prohibited activities, such as presenting or causing to be presented a claim to a GHC Program that the person knows or should know is for an item or service that was not provided as claimed or for a claim that is false or fraudulent, or providing
remuneration to a GHC Program beneficiary that the person or entity knows or should know is likely to influence the beneficiary&#146;s selection of a provider or supplier. Regulators also have the authority to exclude individuals and entities from
participation in GHC Programs under the Civil Monetary Penalties Law. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The civil and administrative false claims statutes are being
applied in a broad range of circumstances. For example, claims for services that are medically unnecessary or fail to meet applicable coverage standards may, under certain circumstances, violate these statutes. Claims for services that were induced
by kickbacks and Stark Law violations may also form the basis for FCA liability. Many of the laws and regulations referenced above can be used in conjunction with each other. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">If we or our affiliated professional contractors were excluded from participation in any GHC Programs, not only would we be prohibited from
submitting claims for reimbursement under such programs, but we also would be unable to contract with other healthcare providers, such as hospitals, to provide services to them. It could also adversely affect our or our affiliated professional
contractors&#146; ability to contract with, or obtain payment from, <FONT STYLE="white-space:nowrap">non-governmental</FONT> payors. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Although we intend to conduct our business in compliance with all applicable federal and state fraud and abuse laws, many of the laws, rules
and regulations applicable to us, including those relating to billing and those relating to financial relationships with physicians and hospitals, are broadly worded and may be interpreted or applied by prosecutorial, regulatory or judicial
authorities in ways that we cannot predict. Accordingly, we cannot assure you that our arrangements or business practices will not be subject to government scrutiny or be alleged or found to violate applicable fraud and abuse laws. If there is a
determination by government authorities that we have not complied with any of these laws, rules and regulations, our business, financial condition and results of operations could be materially, adversely affected. See &#147;Government
Investigations.&#148; </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Government Regulatory Requirements </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In order to participate in the Medicare program and in the various state Medicaid programs, we and our affiliated physician practices must
comply with stringent and often complex regulatory requirements. Moreover, different states impose varying standards for their Medicaid programs. While our compliance program requires that we and our affiliated physician practices adhere to the
laws, rules and regulations applicable to the </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>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
government programs in which we participate, our failure to comply with these laws, rules and regulations could negatively affect our business, financial condition and results of operations. See
&#147;Government Regulation&#151;Fraud and Abuse Provisions,&#148; &#147;Government Regulation&#151;Compliance Program,&#148; &#147;Government Investigations&#148; and &#147;Other Legal Proceedings,&#148; and Item 1A. Risk Factors &#151;
&#147;Government-funded programs, private insurers or state laws and regulations may limit, reduce or make retroactive adjustments to reimbursement amounts or rates,&#148; &#147;We may become subject to billing investigations by federal and state
government authorities&#148; and &#147;The healthcare industry is highly regulated, and government authorities may determine that we have failed to comply with applicable laws, rules or regulations.&#148; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, GHC Programs are subject to statutory and regulatory changes, administrative rulings, interpretations and determinations, manual
guidance, requirements for utilization review and new governmental funding restrictions, all of which may materially increase or decrease program payments, as well as affect the cost of providing services and the timing of payments to providers.
Moreover, because these GHC programs generally provide for reimbursement on a fee-schedule, <FONT STYLE="white-space:nowrap">per-service</FONT> or <FONT STYLE="white-space:nowrap">per-discharge</FONT> basis rather than on a charge-related basis, we
generally cannot increase our revenue through increases in the amount we charge for our services. To the extent our costs increase, we may not be able to recover our increased costs from these programs, and cost containment measures and market
changes in <FONT STYLE="white-space:nowrap">non-governmental</FONT> insurance plans have generally restricted our ability to recover or shift these increased costs to <FONT STYLE="white-space:nowrap">non-governmental</FONT> payors. In attempts to
limit federal and state spending, there have been, and we expect that there will continue to be, a number of proposals to limit or reduce Medicare and Medicaid reimbursement for various services. Our business may be significantly and adversely
affected by any such changes in reimbursement policies and other legislative initiatives aimed at reducing healthcare costs associated with Medicare, Medicaid and other GHC programs. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our business also could be adversely affected by reductions in or limitations of funding of GHC programs or restrictions on or elimination of
coverage for certain individuals or treatments under these programs. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Antitrust </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The healthcare industry is subject to close antitrust scrutiny. The Federal Trade Commission (&#147;FTC&#148;), the Antitrust Division of the
DOJ and state Attorneys General all actively review and, in some cases, take enforcement action against business conduct and acquisitions in the healthcare industry. Private parties harmed by alleged anticompetitive conduct can also bring antitrust
suits. Violations of antitrust laws may be punishable by substantial penalties, including significant monetary fines, civil penalties, criminal sanctions, consent decrees and injunctions prohibiting certain activities or requiring divestiture or
discontinuance of business operations. Any of these penalties could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>HIPAA and Other Privacy, Security and Breach Notification Laws </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Numerous federal and state laws, rules and regulations govern the collection, dissemination, use, privacy, security and confidentiality of
personal information. For example, the federal Health Insurance Portability and Accountability Act of 1996, as amended, and its implementing regulations (collectively, &#147;HIPAA&#148;) impose requirements to protect the privacy and security of
protected health information (&#147;PHI&#148;) and to provide notification in the event of a breach of PHI. Violations of HIPAA are punishable by civil money penalties and, in some cases, criminal penalties and imprisonment. The U.S. Department of
Health and Human Services (&#147;HHS&#148;) Office for Civil Rights (&#147;OCR&#148;), which is responsible for enforcing HIPAA, also may enter into resolution agreements requiring the payment of a civil money penalty and/or the establishment of a
corrective action plan to address violations of HIPAA. OCR may also take other actions short of requiring payment of a civil money penalty or a corrective action plan, such as the provision of technical assistance. As part of our business
operations, including in connection with medical record keeping, third-party billing, research and other services, we and our affiliated physician practices collect and maintain PHI regarding patients, which subjects us to compliance with HIPAA
requirements. </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">23 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Pursuant to HIPAA, HHS has adopted privacy regulations, known as the privacy rule, to govern the
use and disclosure of PHI (the &#147;Privacy Rule&#148;). The Privacy Rule applies to &#147;Covered Entities,&#148; which are health plans, health care clearinghouses, and health care providers that engage in standardized transactions under HIPAA,
and, as discussed further below, &#147;Business Associates,&#148; which are entities that perform functions or services for or on behalf of Covered Entities that involve the use or disclosure of PHI. The term &#147;Business Associate&#148; also
includes &#147;Subcontractors,&#148; which means any entity to whom a Business Associate delegates any function, activity or service, other than in the capacity of a member of the Business Associate&#146;s workforce. PHI is broadly defined as any
individually identifiable health information transmitted or maintained in any form, including electronic, paper or oral. As a general rule, a Covered Entity or Business Associate may not use or disclose PHI except as permitted under the Privacy
Rule. We have implemented privacy policies and procedures, including training programs, designed to comply with the requirements set forth in the Privacy Rule, as amended to reflect changes required by HITECH, as discussed further below. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">HHS has also adopted data security regulations (the &#147;Security Rule&#148;) that require Covered Entities (including health care providers)
and Business Associates to implement administrative, physical and technical safeguards to protect the integrity, confidentiality and availability of PHI that is electronically created, received, maintained or transmitted (such as between us and our
affiliated practices). We have implemented security policies, procedures and systems, including training programs, designed to comply with the requirements set forth in the Security Rule. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, Congress enacted the Health Information Technology for Economic and Clinical Health (&#147;HITECH&#148;) Act as part of the
American Recovery and Reinvestment Act. Among other changes to the laws governing PHI, HITECH required OCR to strengthen and expand HIPAA requirements, increase penalties for violations, give patients new rights to restrict uses and disclosures of
their PHI, and impose a number of privacy and security requirements directly on Business Associates, which are now directly subject to penalties under HIPAA as a result of HITECH. Notably, as a result of HITECH, a Covered Entity is liable for
violations of HIPAA resulting from the acts or omissions of any Business Associate acting as its agent, as determined by the federal common law of agency. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Under HIPAA, as amended by regulations promulgated pursuant to HITECH, Covered Entities are required to report any unauthorized use or
disclosure of PHI that meets the definition of a breach to affected individuals, HHS and, depending on the number of affected individuals, the media for the affected market. In addition, HIPAA requires that Business Associates report breaches to
their Covered Entity customers. HITECH further authorizes state Attorneys General to bring civil actions in response to violations of HIPAA that threaten the privacy of state residents. We have adopted breach notification policies and procedures
designed to comply with the applicable requirements set forth in HIPAA. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">HIPAA establishes a federal &#147;floor&#148; with respect to
privacy, security, and breach notification requirements and does not supersede any state laws insofar as they are broader or more stringent than HIPAA. Numerous state and certain other federal laws protect the confidentiality of patient information
and other personal information, including but not limited to state medical privacy laws, state laws protecting personally identifiable information, state data breach notification laws, state genetic privacy laws, human subjects research laws and
federal and state consumer protection laws. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">These requirements are also subject to change. Compliance with new privacy, security, and
breach notification laws, regulations and requirements may result in increased operating costs, and may constrain or require us to alter our business model or operations. For example, changes to HIPAA promulgated pursuant to HITECH further
restricted our ability to collect, disclose and use PHI and imposed additional compliance requirements on us. </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">24 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>HIPAA Transaction Requirements </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition to privacy, security, and breach notifications requirements, HIPAA establishes uniform electronic data transmission standards that
all healthcare providers must use for electronic healthcare transactions. For example, claims for reimbursement that are transmitted electronically to third-party payors must comply with specific formatting standards, and these standards apply
whether the payor is a government or a private entity. We report medical diagnoses under International Classification of Diseases, 10<SUP STYLE="font-size:85%; vertical-align:top">th</SUP> Edition
<FONT STYLE="white-space:nowrap">(&#147;ICD-10&#148;).</FONT> If claims are not reported properly under <FONT STYLE="white-space:nowrap">ICD-10</FONT> due to technical or coding errors or other implementation issues involving systems, including ours
and those of our third-party payors, there can be a delay in the processing and payment of such claims, or a denial of such claims, which could have a material adverse effect on our business, financial condition, results of operations, cash flows
and the trading price of our securities. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Environmental Regulations </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our healthcare operations generate medical waste that must be disposed of in compliance with federal, state and local environmental laws, rules
and regulations. Our office-based operations are subject to compliance with various other environmental laws, rules and regulations. Such compliance does not, and we anticipate that such compliance will not, materially affect our capital
expenditures, financial position or results of operations. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Compliance Program </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We maintain a compliance program that includes the established elements of an effective program and reflects our commitment to complying with
all laws, rules and regulations applicable to our business and that meets our ethical obligations in conducting our business (the &#147;Compliance Program&#148;). We believe our Compliance Program provides a solid framework to meet this commitment
and our obligations as a provider of healthcare services, including: </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="8%">&nbsp;</TD>
<TD WIDTH="1%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">a Chief Compliance Officer who reports to the Board of Directors on a regular basis; </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="1%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">a Compliance Committee consisting of our senior executives; </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="1%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">a formal internal audit function, including a Senior Director of Internal Audit who reports to the Audit
Committee on a regular basis; </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="1%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">our <I>Code of Conduct</I>, which is applicable to our employees, independent contractors, officers and
directors; </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="1%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">our <I>Code of Professional Conduct &#150; Finance</I>, which is applicable to our finance personnel, including
our Chief Executive Officer, Chief Financial Officer and Chief Accounting Officer; </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="1%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">a disclosure program that includes a mechanism to enable individuals to disclose on a confidential or anonymous
basis to the Chief Compliance Officer or any person who is not in the disclosing individual&#146;s chain of command, issues or questions believed by the individual to be a potential violation of criminal, civil, or administrative laws or of company
policies or procedures; </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="1%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">an organizational structure designed to integrate our compliance objectives into our corporate offices, regions
and practices; 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="1%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">education, monitoring and corrective action programs designed to establish methods to promote the understanding
of our Compliance Program and adherence to its requirements. </P></TD></TR></TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The foundation of our Compliance Program is our <I>Code of
Conduct</I>, which is intended to be a comprehensive statement of the ethical and legal standards governing the daily activities of our employees, affiliated professionals, independent contractors, officers and directors. All of our personnel are
required to abide by, and are given thorough education regarding, our <I>Code of Conduct</I>. In addition, all employees and affiliated </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">25 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
professionals are expected to report incidents that they believe in good faith may be in violation of our <I>Code of Conduct</I>. We maintain a toll-free helpline to permit individuals to report
compliance concerns on an anonymous basis and obtain answers to questions about our <I>Code of Conduct</I>. Our Compliance Program, including our <I>Code of Conduct</I>, is administered by our Chief Compliance Officer with oversight by our Chief
Executive Officer, Compliance Committee and Board of Directors. Copies of our <I>Code of Conduct</I> and our <I>Code of Professional Conduct &#150; Finance</I> are available on our website, www.mednax.com. Our internet website and the information
contained therein or connected thereto are not incorporated into or deemed a part of this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> Any amendments or waivers to our <I>Code of Professional Conduct &#150; Finance</I> will be promptly
disclosed on our website following the date of any such amendment or waiver. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>GOVERNMENT INVESTIGATIONS </B></P>
<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, agencies, contractors and payors will occur in the ordinary
course of business. Such audits, inquiries and investigations and their ultimate resolutions, individually or in the aggregate, could have a material adverse effect on our business, financial condition, results of operations, cash flows and the
trading price of our securities. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>OTHER LEGAL PROCEEDINGS </B></P>
<P STYLE="margin-top:6pt; 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 and the trading price of our securities. The outcome of such actions and proceedings, however, cannot be predicted with
certainty and an unfavorable resolution of one or more of them could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In July 2018, a securities class action lawsuit was filed against us and certain of our officers and one of our directors 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="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 ensure that our insurance coverage will be adequate to cover liabilities arising out of claims asserted against us in the future where the outcomes of such claims are unfavorable to us. With respect to
professional liability risk, we self-insure a significant portion of this risk through our wholly owned captive insurance subsidiary. Liabilities in excess of our insurance coverage, including coverage for professional liability and certain other
claims, could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. See &#147;Professional and General Liability Coverage.&#148; </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>PROFESSIONAL AND GENERAL LIABILITY COVERAGE </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We maintain professional and general liability insurance policies with third-party insurers generally on a claims-made basis, subject to
deductibles, self-insured retention limits, policy aggregates, exclusions, and other restrictions, in accordance with standard industry practice. We believe that our insurance coverage is appropriate based upon our claims experience and the nature
and risks of our business. However, we cannot predict whether </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">26 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
any pending or future claim would be successful or, if successful, would not exceed the limits of available insurance coverage. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our business entails an inherent risk of claims of medical malpractice against our affiliated physicians, clinicians and us. We contract and
pay premiums for professional liability insurance that indemnifies us and our affiliated healthcare professionals generally on a claims-made basis for losses incurred related to medical malpractice litigation. Professional liability coverage is
required in order for our affiliated physicians to maintain hospital privileges. Our self-insured retention under our professional liability insurance program is maintained primarily through a wholly owned captive insurance subsidiary. We record
estimates in our Consolidated Financial Statements for our liabilities for self-insured retention amounts and claims incurred but not reported based on an actuarial valuation using historical loss information, claim emergence patterns and various
actuarial assumptions. Liabilities for claims incurred but not reported are not discounted. Because many factors can affect historical and future loss patterns, the determination of an appropriate reserve involves complex, subjective judgment, and
actual results may vary significantly from estimates. If the self-insured retention amounts and other amounts that we are actually required to pay materially exceed the estimates that have been reserved, our financial condition, results of
operations and cash flows could be materially, adversely affected. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>EMPLOYEES AND PROFESSIONALS UNDER CONTRACT </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition to the 4,210 practicing physicians affiliated with us as of December&nbsp;31, 2018, we employed or contracted with approximately
4,250 other clinical professionals and approximately 7,625 other full-time and part-time employees. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>GEOGRAPHIC COVERAGE </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We provide physician services across all 50 states, the District of Columbia and Puerto Rico. In addition, through our complementary service
businesses, we provide full service revenue cycle management and consulting services to healthcare facilities and physicians nationwide. During 2018, approximately 52% of our net revenue was generated by operations in our five largest states. Our
operations in Texas accounted for approximately 20% of our net revenue for the same period. Although we continue to seek to diversify the geographic scope of our operations, primarily through acquisitions of physician group practices, we may not be
able to implement successfully or realize the expected benefits of any of these initiatives. Adverse changes or conditions affecting states in which our operations are concentrated, such as healthcare reforms, changes in laws, rules and regulations,
reduced Medicare or Medicaid reimbursements, an increase in the income level required to qualify for government healthcare programs or government investigations, may have a material adverse effect on our business, financial condition, results of
operations, cash flows and the trading price of our securities. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>SERVICE MARKS </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have registered with the United States Patent and Trademark Office the service marks &#147;MEDNAX National Medical Group and Design,&#148;
&#147;Pediatrix Medical Group and Design,&#148; &#147;Obstetrix Medical Group and Design,&#148; &#147;American Anesthesiology and Design,&#148; &#147;BabySteps,&#148; the &#147;Baby Design,&#148; &#147;Quality Steps,&#148; &#147;iNewborn,&#148;
&#147;NEO Conference and Design,&#148; &#147;MedData&#148; and &#147;vRad,&#148; among others. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>AVAILABLE INFORMATION </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our annual proxy statements, annual reports on Form <FONT STYLE="white-space:nowrap">10-K,</FONT> quarterly reports on Form <FONT
STYLE="white-space:nowrap">10-Q,</FONT> current reports on Form <FONT STYLE="white-space:nowrap">8-K</FONT> and amendments to those statements and reports filed or furnished pursuant to Section&nbsp;13(a) or 15(d) of the Securities Exchange Act of
1934 are available free of charge and may be printed out through our internet website, www.mednax.com, as soon as reasonably practicable after we electronically file such material with, or furnish it to, the SEC. Our proxy statements and reports may
also be obtained directly from the SEC&#146;s Internet website at www.sec.gov. Our internet website and the information contained therein or connected thereto are not incorporated into or deemed a part of this Form
<FONT STYLE="white-space:nowrap">10-K.</FONT> </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">27 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_2"></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"><I>Our business is subject to a number of factors that could materially affect future developments and performance. In addition to factors
affecting our business that have been described elsewhere in this Form <FONT STYLE="white-space:nowrap">10-K,</FONT> any of the following risks could have a material adverse effect on our business, financial condition, results of operations, cash
flows and the trading price of our securities. </I></P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Economic conditions could have an adverse effect on our business. </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.&nbsp;During the year ended December&nbsp;31, 2018, the percentage
of our patient service revenue being reimbursed under GHC Programs remained relatively consistent as compared to the year ended December&nbsp;31, 2017. If, however, economic conditions in the United States deteriorate, we could experience shifts
toward GHC Programs, and patient volumes could decline. Further, we could experience and have experienced shifts toward GHC Programs if changes occur in population demographics within geographic locations in which we provide services. We have also
experienced, and expect to continue to experience, a shift toward GHC Programs in anesthesia care. Adverse economic conditions could also lead to additional increases in the number of unemployed and under-employed workers and a decline in the number
of private employers that offer healthcare insurance coverage to their employees. Employers that do offer healthcare coverage may increase the required contributions from employees to pay for their coverage and increase patient responsibility
amounts. In addition, certain private payors&#146; poor experience with the healthcare insurance exchanges and uncertainty around the future of the ACA and healthcare insurance exchanges may result in those payors exiting the healthcare insurance
exchange marketplaces or the cessation of the healthcare insurance exchanges. As a consequence, the number of patients who participate in GHC Programs or who are uninsured or underinsured could increase. Payments received from GHC Programs are
substantially less than payments received from private healthcare insurance programs (managed care and other third-party payors). Payments under policies issued through the healthcare insurance exchanges may be less than payments from private
healthcare insurance programs and in some cases, patients&#146; responsibility for costs related to healthcare plans obtained through the healthcare insurance exchanges may be high and could increase in the future, and we may experience increased
bad debt due to patients&#146; inability to pay for certain services. A payor mix shift from private healthcare insurance programs to GHC Programs or to healthcare insurance exchanges may result in an increase in our estimated provision for
contractual adjustments and uncollectibles and a corresponding decrease in our net revenue, as well as a significant reduction in our average reimbursement rates. While we have developed a number of strategic initiatives across our organization, in
both our shared services functions and our operational infrastructure, to address some of the effects of changes in economic conditions, there is no assurance that these initiatives will be successful in generating improvements in our general and
administrative expenses and our operational infrastructure. If these initiatives are unsuccessful, it 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:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>The ACA and potential changes to it may have a significant effect on our business. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The ACA contains a number of provisions that have affected us and 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. 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 flux and uncertainty. In 2017, Congress unsuccessfully sought to replace
substantial parts of the ACA with different mechanisms for facilitating insurance coverage in the commercial and Medicaid markets. Additionally, CMS has administratively revised a number of provisions and may seek to advance additional significant
changes through regulation, guidance and </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">28 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
enforcement in the future. At the end of 2017, Congress repealed part of the ACA that required most individuals to purchase and maintain health insurance or face a tax penalty, known as the
individual mandate. In December 2018, a federal judge in Texas declared that key portions of the ACA were inconsistent with the United States Constitution and specifically that the ACA cannot stand on its own since Congress repealed the individual
mandate. Several states are now engaged in appealing this decision. It is possible that as a result of these actions, enrollment in healthcare exchanges declined during 2018. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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">We cannot ultimately 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:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>The Medicare Access and CHIP Reauthorization Act of 2015 (&#147;MACRA&#148;) and potential changes to it may have a significant effect on our business.
</B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">MACRA contains numerous measures that could affect us, including, requirements that physicians participate in quality measurement
programs that differentiate payments to physicians under Medicare based on quality and cost of care, rather than the quantity of procedures performed. MACRA requires physicians to choose to participate in one of two payment formulas, MIPS 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 APMs, and physicians who are meaningful participants in APMs will receive bonus payments from Medicare pursuant to the
law. MACRA also remains subject to review and potential modification by Congress, as well as shifting regulatory requirements established by CMS. 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 ultimately 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">29 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>State budgetary constraints and the uncertainty over the future of Medicaid could have an adverse effect on
our reimbursement from Medicaid programs. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Congress and the current Administration have expressed interest in repealing, and have
attempted to repeal, the ACA and substantially reform the Medicaid program. Congress could, for example, repeal the provisions of the ACA that encouraged states to expand Medicaid eligibility to more adults, including additional federal matching
funds that enabled states to do so. The ACA allowed states to expand their Medicaid programs through federal payments that fund most of the cost of increasing the Medicaid eligibility income limit from a state&#146;s historic eligibility levels to
133% of the federal poverty level. As of December&nbsp;31, 2018, 36 states and the District of Columbia implemented the expansion of Medicaid eligibility. All of the states in which we operate, however, already cover children in the first year of
life and pregnant women if their household incomes are at or below 133% of the federal poverty level. If states that expanded Medicaid reduce or eliminate eligibility for certain individuals, the number of patients who are uninsured could increase.
Some states may seek to maintain expanded eligibility and to do so could offset the cost by further reducing payments to providers of services. In some states, we could experience delayed or reduced Medicaid payment for services furnished to program
enrollees. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Congress and the current Administration are also seeking substantial reforms to Medicaid law to grant states more autonomy and
discretion to design Medicaid programs. These changes, if enacted, could reduce or eliminate eligibility for certain individuals, or allow states to reduce payments to providers of services. As a result, in some states, we could experience an
increase in the number of uninsured patients and delayed or reduced Medicaid payment for services furnished to program enrollees. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The
2018 <FONT STYLE="white-space:nowrap">mid-term</FONT> elections in November 2018 changed the balance of power in Congress and may change the direction of future health-related legislation. More recently, a federal judge in Texas declared that key
portions of the ACA were inconsistent with the United States Constitution and specifically that the ACA cannot stand on its own since Congress repealed the individual mandate. Several states are now engaged in appealing this decision. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, many states are continuing to collect less tax revenue than they did historically and as a consequence continue to face budget
shortfalls and underfunded pension and other obligations. Although shortfalls have been declining in more recent budgetary years, they are still significant by historical standards. The financial condition of the states in which we do business could
lead to reduced or delayed funding for Medicaid programs and, in turn, reduced or delayed reimbursement for physician services, which could adversely affect our results of operations, cash flows and financial condition. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>The birth rate in the United States has declined and may decline further. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Final birth data for 2017 indicate that total births in the United States declined by approximately 2% as compared to 2016. Provisional data
for 2018 is not yet available; however, we expect that birth trends at the hospitals where we provide services will continue to be soft in the near future. Future declines in births are possible and could have an adverse effect on our patient
volumes, net revenue, results of operations, cash flows and financial condition. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Expanding eligibility of GHC Programs could adversely affect our
reimbursement. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In January 2018, Congress reauthorized the Children&#146;s Health Insurance Program (&#147;CHIP&#148;) through 2023 and
then in February 2018 lengthened this funding extension through 2027. Changes to CHIP or the ACA&#146;s expansion of Medicaid coverage could cause patients who otherwise would have participated in private healthcare insurance programs to participate
in GHC Programs, or vice versa, or cause patients who otherwise would have been covered by CHIP or Medicaid to lose insurance coverage altogether. Additional reform efforts, as well as legislative or administrative amendment or repeal of the ACA,
could change the eligibility </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">30 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
requirements for Medicaid and for other GHC Programs, including CHIP, and could increase the number of patients who participate in such programs or the number of uninsured patients. In general,
payments received from GHC Programs are substantially less than payments received from private healthcare insurance programs (managed care and other third-party payors). A shift in the mix of our payors from private healthcare insurance programs to
government payors may result in an increase in our estimated provision for contractual adjustments and uncollectibles and a corresponding decrease in our net revenue, as well as a significant reduction in our average reimbursement rates.
Additionally, if Congress does not act to extend CHIP beyond 2027, or if Congress extends CHIP but substantially alters the current program, we could be adversely affected if children in states where we do business lose Medicaid coverage or payments
for services furnished to these children are delayed or reduced. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Government-funded programs, private insurers or state laws and regulations may limit,
reduce or make retroactive adjustments to reimbursement amounts or rates. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">A significant portion of our net revenue is derived from
payments made by GHC Programs, principally Medicare and Medicaid. These government-funded programs, as well as private insurers, have been and may continue to be subject to changes, including increased use of managed care organizations, value-based
purchasing, and new patient care models to control the cost, eligibility for, use and delivery of healthcare services as a result of budgetary constraints and cost containment pressures due to unfavorable economic conditions, rising healthcare costs
and for other reasons, including those described above under Item 1. Business&#151;&#147;Government Regulation&#151;Government Regulatory Requirements.&#148; Federal and state legislatures or administrators of these government-funded programs and
private insurers may attempt other measures to control costs, including bundling of services and denial of, or reduction in, reimbursement for certain services and treatments. In addition, increased consolidation among private insurers is resulting
in fewer and larger third-party payors with increased negotiating power. As a result, payments from government programs or private payors may decrease significantly. Also, any adjustment in Medicare reimbursement rates may have a detrimental impact
on our reimbursement rates not only for Medicare patients, but also for patients covered under Medicaid and other third-party payors, because a state&#146;s Medicaid payments cannot exceed the payments it would have made had those patients been
enrolled in traditional Medicare, and other third-party payors often base their reimbursement rates on a percentage of Medicare rates. Our business may also be materially affected by limitations on, or reductions in, reimbursement amounts or rates
or elimination of coverage for certain individuals or treatments. Moreover, because government-funded programs generally provide for reimbursements on a <FONT STYLE="white-space:nowrap">fee-schedule</FONT> basis rather than on a charge-related
basis, we generally cannot increase our revenue from these programs through increases in the amount we charge for our services. To the extent our costs increase, we may not be able to recover our increased costs from these programs, and cost
containment measures and market changes in <FONT STYLE="white-space:nowrap">non-government-funded</FONT> insurance plans have generally restricted our ability to recover, or shift to <FONT STYLE="white-space:nowrap">non-governmental</FONT> payors,
these increased costs. In addition, funds we receive from third-party payors are subject to audit with respect to the proper billing for physician and ancillary services and, accordingly, our revenue from these programs may be adjusted
retroactively. Any retroactive adjustments to our reimbursement amounts could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, our agreements with certain third-party payors may be terminated for various reasons, requiring us to seek reimbursement as an <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-network</FONT></FONT> provider. In the event we attempt to balance-bill patients, we may be limited in our ability to do so by certain state laws and regulations. As these laws and
regulations continue to develop in certain states, it could incentivize certain third-party payors to terminate agreements as a business strategy which could lower overall reimbursement to providers. Any reductions in reimbursement amounts could
have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. Further, if a federal government shutdown were to occur for a prolonged period of time, federal
government payment obligations, including its obligations under Medicaid and Medicare, may be delayed. Similarly, if state government shutdowns were to occur, state payment obligations may be delayed. If
</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">31 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
the federal or state governments fail to make payments under these programs on a timely basis, our business could suffer, and our financial position, results of operations or cash flows may be
materially affected. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>We may become subject to billing investigations by federal and state government authorities and private insurers. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Federal and state laws, rules and regulations impose substantial penalties, including criminal and civil fines, monetary penalties, exclusion
from participation in government healthcare programs and imprisonment, on entities or individuals (including any individual corporate officers or individual providers deemed responsible) that fraudulently or wrongfully bill government-funded
programs or other third-party payors for healthcare services. CMS requires states to maintain a Medicaid Recovery Audit Contractor (&#147;RAC&#148;) program. States are required to contract with one or more eligible Medicaid RACs to review Medicaid
claims for any overpayments or underpayments, and to recoup overpayments from providers on behalf of the state. In addition, federal laws, along with a growing number of state laws, allow a private person to bring a civil action in the name of the
government for false billing violations. See Item 1. Business&#151;&#147;Government Regulation&#151;Fraud and Abuse Provisions.&#148; Moreover, the current Administration has expressed a desire to increase scrutiny of providers and payments for
services to further minimize fraud and abuse of the program. In addition, our contracts with private insurers often provide such insurers with audit rights over payments made to us and the ability to seek recoupment for overpayments. We believe that
audits, inquiries and investigations from government agencies and private insurers will occur from time to time in the ordinary course of our business, which could result in substantial costs to us and a diversion of management&#146;s time and
attention. New regulations and heightened enforcement activity also could materially affect our cost of doing business and our risk of becoming the subject of an audit or investigation. We cannot predict whether any future audits, inquiries or
investigations, or the public disclosure of such matters, likely would have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. See Item 1.
Business&#151;&#147;Government Investigations.&#148; </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>The healthcare industry is highly regulated, and government authorities may determine that we
have failed to comply with applicable laws, rules or regulations. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The healthcare industry and physicians&#146; medical practices,
including the healthcare and other services that we and our affiliated physicians provide, are subject to extensive and complex federal, state and local laws, rules and regulations, compliance with which imposes substantial costs on us. Of
particular importance are the provisions summarized as follows: </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">federal laws (including the federal FCA) that prohibit entities and individuals from intentionally (or with
reckless disregard or deliberate ignorance) presenting or causing to be presented false or fraudulent claims to Medicare, Medicaid and other government-funded programs, or improperly retaining known overpayments; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">a provision of the Social Security Act, commonly referred to as the &#147;anti-kickback&#148; statute, that
prohibits the knowing and willful offer, payment, solicitation or receipt of any bribe, kickback, rebate or other remuneration, in cash or in kind, in return for the referral or recommendation of patients for, or for the purchasing, leasing,
ordering or arranging for, items and services for which payment may be made, in whole or in part, by federal healthcare programs, such as Medicare and Medicaid; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">a provision of the Social Security Act, commonly referred to as the Stark Law, that, subject to certain
exceptions, prohibits physicians from making a referral to an entity for certain &#147;designated health services&#148; if the physician, or an immediate family member, has a direct or indirect financial relationship (including a compensation
arrangement) with the entity; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">similar state law provisions pertaining to anti-kickback, fee splitting, self-referral and false claims, which
typically are not limited to relationships involving government-funded programs; </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">32 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">provisions of HIPAA that prohibit knowingly and willfully executing a scheme or artifice to defraud a healthcare
benefit program or falsifying, concealing or covering up a material fact or making any material false, fictitious or fraudulent statement in connection with the delivery of or payment for healthcare benefits, items or services;
</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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">federal and state laws related to confidentiality, privacy and security of personal information, including
medical information and records, that limit the manner in which we may use and disclose that information, impose obligations to safeguard that information and require that we notify third parties in the event of a breach; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">state laws that prohibit general business corporations from practicing medicine, controlling physicians&#146;
medical decisions or engaging in certain practices, such as splitting fees with physicians; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">federal and state laws governing participation in GHC Programs could result in denial of our application to
become a participating provider or revocation of our participation or billing privileges, which in turn, could cause us to not be able to treat patients covered by the applicable program or prohibit us from billing for the treatment services
provided to such patients; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">federal and state laws that prohibit providers from billing and receiving payment from Medicare and Medicaid for
services unless the services are medically necessary, adequately and accurately documented and billed using codes that accurately reflect the services rendered; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">federal and state laws pertaining to the provision and coverage of services by
<FONT STYLE="white-space:nowrap">non-physician</FONT> practitioners, such as advanced nurse practitioners, physician assistants and other clinical professionals, physician supervision of such services and reimbursement requirements that may be
dependent on the manner in which the services are provided and documented; and </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">federal laws that impose civil administrative sanctions for, among other violations, inappropriate billing of
services to federal healthcare programs, inappropriately reducing hospital inpatient lengths of stay for such patients, or employing individuals who are excluded from participation in federally funded healthcare programs. </P></TD></TR></TABLE>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, we believe that our business will continue to be subject to increasing regulation, the scope and effect of which we cannot
predict. See Item 1. Business&#151;&#147;Government Regulation.&#148; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We may in the future become the subject of regulatory or other
investigations, audits or proceedings, and our interpretations of applicable laws, rules and regulations may be challenged. For example, regulatory authorities or other parties may assert that our arrangements with our affiliated professional
contractors constitute fee splitting or the corporate practice of medicine and seek to invalidate these arrangements, which could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading
price of our securities. See Item 1. Business&#151;&#147;Government Regulation&#151;Fee Splitting; Corporate Practice of Medicine.&#148; Regulatory authorities or other parties also could assert that our relationships, including fee arrangements,
among our affiliated professional contractors, hospital clients or referring physicians violate the anti-kickback, fee splitting or self-referral laws and regulations or that we have submitted false claims or otherwise failed to comply with
government program reimbursement requirements. See Item 1. Business&#151;&#147;Government Regulation&#151;Fraud and Abuse Provisions&#148; and &#147;&#151;Government Regulatory Requirements.&#148; Such investigations, proceedings and challenges
could result in substantial defense costs to us and a diversion of management&#146;s time and attention. In addition, violations of these laws are punishable by monetary fines, civil and criminal penalties, exclusion from participation in GHC
Programs, and forfeiture of amounts collected in violation of such laws and regulations, any of which could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our
securities. </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">33 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Federal and state laws that protect the privacy and security of personal information may increase our costs
and limit our ability to collect and use that information and subject us to liability if we are unable to fully comply with such laws. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Numerous federal and state laws, rules and regulations govern the collection, dissemination, use, security and confidentiality of personal
information, including individually identifiable health information. These laws include: </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">Provisions of HIPAA that limit how covered entities and business associates may use and disclose PHI, provide
certain rights to individuals with respect to that information and impose certain security requirements; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">HITECH, which required OCR to strengthen and expand the HIPAA Privacy Rule and Security Rule and imposes data
breach notification obligations; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">Other federal and state laws restricting the use and protecting the privacy and security of personal information,
including health information, many of which are not preempted by HIPAA; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">Federal and state consumer protection laws; 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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">Federal and state laws regulating the conduct of research with human subjects. </P></TD></TR></TABLE>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As part of our business operations, including our medical record keeping, third-party billing, research and other services, we collect and
maintain PHI in paper and electronic format. Standards related to health information, whether implemented pursuant to HIPAA, HITECH, state laws, federal or state action or otherwise, could have a significant effect on the manner in which we handle
personal information, including PHI, and communicate with payors, providers, patients and others, and compliance with these standards could impose significant costs on us or limit our ability to offer services, thereby negatively impacting the
business opportunities available to us. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">If we are alleged to not comply with existing or new laws, rules and regulations related to PHI
or other personal information we could be subject to litigation and to sanctions that include monetary fines, civil or administrative penalties, civil damage awards or criminal penalties. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Government authorities or other parties may assert that our business practices violate antitrust laws. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The healthcare industry is subject to close antitrust scrutiny. The FTC, the Antitrust Division of the DOJ and state Attorneys General all
actively review and, in some cases, take enforcement action against business conduct and acquisitions in the healthcare industry. Private parties harmed by alleged anticompetitive conduct can also bring antitrust suits. Violations of antitrust laws
may be punishable by substantial penalties, including significant monetary fines and treble damages, civil penalties, criminal sanctions, and consent decrees and injunctions prohibiting certain activities or requiring divestiture or discontinuance
of business operations. Any of these penalties could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Our affiliated physicians and other individual providers may not appropriately record or document services that they provide. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our affiliated physicians and other individual providers are responsible for appropriately recording and documenting the services that they
provide. We use this information to seek reimbursement for their services from third-party payors. In addition, we utilize third-party contractors to perform certain revenue cycle management functions for healthcare providers, including medical
coding. If our affiliated physicians or other individual providers and third-party contractors do not appropriately document, or where applicable, code for their services or our customers&#146; services, we could be subjected to administrative,
regulatory, civil, or criminal investigations or sanctions and our business, financial condition, results of operations and cash flows could be materially adversely affected. </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">34 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Failure to manage third-party service providers may adversely affect our ability to maintain the quality of
service that we provide. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We outsource a certain portion of our revenue cycle management functions to third-party service providers,
but we may increase the amount of revenue cycle management functions we outsource in the future. These functions are performed both domestically and in offshore locations, with our oversight. If our outsourcing partners fail to perform their
obligations in a timely manner or at satisfactory quality levels or if they are unable to attract or retain sufficient personnel with the necessary skill sets to meet our outsourcing needs, the efficiency, effectiveness and quality of our services
could suffer. In addition, our reliance on a workforce in other countries exposes us to disruptions in the business, political and economic environment in those regions. Further, any changes to existing laws or the enactment of new legislation
restricting offshore outsourcing in the United States may adversely affect our ability to outsource functions to third-party offshore service providers. Our ability to manage any difficulties encountered could be largely outside of our control. In
addition, payors may have prohibitions or restrictions on the use of third-party service providers and/or require notice for the use of such third-party service providers. Diminished service quality from outsourcing, our inability to utilize
offshore service providers or the failure to comply with restrictions on the use of third-party service providers could have an adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our
securities. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>We may not find suitable acquisition candidates or successfully integrate our acquisitions. Our acquisitions may expose us to greater
business risks and could affect our payor mix. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have expanded and continue to seek to expand our presence in new and existing
metropolitan areas by acquiring established neonatal, radiology, anesthesia, maternal-fetal, pediatric cardiology and other complementary pediatric subspecialty physician group practices. Also, both independently and in collaboration with our
hospital partners, we may seek to expand into other specialties and subspecialties. In addition, we have acquired physician and other healthcare services companies that are complementary to our physician practices. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our acquisition strategy involves numerous risks and uncertainties, including: </P>
<P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">We may not be able to identify suitable acquisition candidates or strategic opportunities or implement
successfully or realize the expected benefits of any suitable opportunities. In addition, we compete for acquisitions with other potential acquirers, some of which may have greater financial or operational resources than we do. This competition may
intensify due to the ongoing consolidation in the healthcare industry, which may increase our acquisition costs. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">We may not be able to complete acquisitions of physician practices or services companies or we may complete
acquisitions on less favorable terms as a result of changes in tax laws, financial market or other economic or market conditions. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">We may not be able to successfully integrate completed acquisitions, including our recent acquisitions.
Integrating completed acquisitions into our existing operations involves numerous short-term and long-term risks, including diversion of our management&#146;s attention, failure to retain key personnel, long-term value of acquired intangible assets
and acquisition expenses. In addition, we may be required to comply with laws, rules and regulations that may differ not only from those of the states in which our operations are currently conducted but from an expansion in the service offerings we
provide in certain states for which the laws, rules and regulations may be different. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">We cannot be certain that any acquired business will continue to maintain its
<FONT STYLE="white-space:nowrap">pre-acquisition</FONT> revenue and growth rates or be financially successful. In addition, we cannot be certain of the extent of any unknown or contingent liabilities of any acquired business, including liabilities
for failure to comply with applicable laws, or liabilities relating to medical malpractice claims. Generally we obtain indemnification agreements from the sellers of businesses acquired with respect to
<FONT STYLE="white-space:nowrap">pre-closing</FONT> acts, omissions and other similar risks. It is possible that we may seek to enforce indemnification provisions </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">35 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="8%">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">
in the future against sellers who may no longer have the financial wherewithal to satisfy their obligations to us. Accordingly, we may incur material liabilities for past activities of acquired
businesses. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">We could incur or assume indebtedness and issue equity in connection with acquisitions. The issuance of shares of
our common stock for an acquisition may result in dilution to our existing shareholders and, depending on the number of shares that we issue, the resale of such shares could affect the trading price of our common stock. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">We may acquire businesses that derive a greater portion of their revenue from GHC Programs than what we recognize
on a consolidated basis or that have business models with lower operating margins than ours. These acquisitions could affect our overall payor mix or operating results in future periods. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">Acquisitions of practices and services companies could entail financial and operating risks not fully
anticipated. Such acquisitions could divert management&#146;s attention and our resources. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">An acquisition could be subject to a challenge under the antitrust laws either before or after it is consummated.
Such a challenge could involve substantial legal costs and divert management&#146;s attention and resources and could result in us having to abandon the transaction or make a divestiture. </P></TD></TR></TABLE>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>We may not be able to successfully execute our same-unit and organic growth strategies. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition to our acquisition growth strategy, we seek opportunities for increasing revenue from our existing operations through same-unit and
organic growth strategies. We also seek opportunities to grow organically outside of our existing operations. We may not be able to successfully execute our same-unit and organic growth strategies for reasons including the following: </P>
<P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">We may not be able to expand the services that our affiliated physicians provide to our hospital partners or the
services provided by our services companies to their customers. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">We may not be able to attract referrals to our office-based practices or neonatology transports to our
hospital-based units. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">We may not be able to execute new contractual arrangements with hospitals, including through joint ventures,
where we either currently provide or do not currently provide physician services. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">We may not be able to work with our hospital partners to develop integrated services programs for which we become
a multi-specialty provider of solutions within the maternal-fetal, newborn, pediatric continuum of care. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">We may not accurately project same-unit and organic growth performance, or we may experience a shift in the mix
of services that certain of our customers request from us, potentially resulting in lower margins. </P></TD></TR></TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, certain
of our organic growth strategies may involve risks and uncertainties similar to those for our acquisition strategy. See &#147;We may not find suitable acquisition candidates or successfully integrate our acquisitions. Our acquisitions may expose us
to greater business risks and could affect our payor mix.&#148; </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>We may not be able to maintain effective and efficient information systems or properly
safeguard our information systems. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our operations are dependent on uninterrupted performance of our information systems. Failure to
maintain reliable information systems, disruptions in our existing information systems or the implementation of new systems could cause disruptions in our business operations, including errors and delays in billings and collections, difficulty
satisfying requirements under hospital contracts, disputes with patients and payors, violations of patient privacy and confidentiality requirements and other regulatory requirements, increased administrative expenses and other adverse consequences.
</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">36 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, information security risks have generally increased in recent years because of new
technologies and the increased activities of perpetrators of cyber-attacks resulting in the theft of protected health, business or financial information. Despite our layered security controls, experienced computer programmers and hackers may be able
to penetrate our information systems and misappropriate or compromise sensitive patient or personnel information or proprietary or confidential information, create system disruptions or cause shutdowns. They also may be able to develop and deploy
viruses, worms and other malicious software programs that disable our systems or otherwise exploit any security vulnerabilities. Outside parties may also attempt to fraudulently induce employees to take actions, including the release of confidential
or sensitive information or to make fraudulent payments, through illegal electronic spamming, phishing or other tactics. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">A failure in or
breach of our information systems as a result of cyber-attacks or other tactics could disrupt our business, result in the release or misuse of PHI, confidential or proprietary business information or cause financial loss, damage our reputation,
increase our administrative expenses, and expose us to additional risk of liability to federal or state governments or individuals. Although we believe that we have reasonable and appropriate information security procedures and other safeguards in
place, which are monitored and routinely tested internally and by external parties, as cyber threats continue to evolve, we may be required to expend additional resources to continue to enhance our information security measures or to investigate and
remediate any information security vulnerabilities. Our remediation efforts may not be successful and could result in interruptions, delays or cessation of service and loss of existing or potential customers and disruption of our operations,
including, without limitation, our billing processes. In addition, breaches of our security measures and the unauthorized dissemination of patient healthcare and other sensitive information, proprietary or confidential information about us, our
patients, clients or customers, or other third-parties, could expose such persons&#146; personal information to the risk of financial or medical identity theft or expose us or such persons to a risk of loss or misuse of this information, result in
litigation and potential liability for us, damage our brand and reputation or otherwise harm our business. Additionally, under certain circumstances, we could be excluded temporarily or permanently from certain commercial or GHC Programs. Any of
these disruptions or breaches of security could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Our employees and business partners may not appropriately secure and protect confidential information in their possession. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of our employees and business partners is responsible for the security of the information in our systems or under our control and to
ensure that private and financial information is kept confidential. Should an employee or business partner not follow appropriate security measures, including those related to cyber threats or attacks or other tactics, as well as our privacy and
security policies and procedures, the improper release of personal information, including PHI, or confidential business or financial information, or misappropriation of assets could result. The release of such information or misappropriation of
assets could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>We may not be able to successfully recruit, onboard and retain qualified physicians and other clinicians and other personnel, and our compensation expense
for existing clinicians and other personnel may increase. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We are dependent upon our ability to recruit and retain a sufficient number
of qualified physicians and other clinicians and other personnel to service existing units at hospitals and our affiliated practices, service our existing customers&#146; radiology read volumes and expand our business. We compete with many types of
healthcare providers, including teaching, research and government institutions, hospitals and health systems and other practice and services groups, for the services of qualified clinicians. We may not be able to continue to recruit new clinicians
or other personnel or renew contracts with existing clinicians or other personnel on acceptable terms. In addition, the recruiting and onboarding process for certain of our physicians and other clinicians can
</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">37 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
take several months, or longer, to complete due to various requirements, including state licensing and hospital credentialing. In addition, if the demand exceeds the supply for physicians and
other clinicians and personnel either in general or in specific markets, we could experience an increase in compensation expense, including premium pay and agency labor costs. If we are unable to recruit new physicians, renew contracts on acceptable
terms or onboard physicians, clinicians and other personnel in a reasonable period of time, our ability to service existing or new hospital units, staff existing or new office-based practices and service our existing or new customer radiology read
volumes could be adversely affected. In addition, if we experience a higher rate of growth in compensation expense, our business, financial condition, results of operations, cash flows and the trading price of our securities could be materially,
adversely affected. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>A significant number of our affiliated physicians or other clinicians could leave our affiliated practices or our affiliated
professional contractors may be unable to enforce the <FONT STYLE="white-space:nowrap">non-competition</FONT> covenants of departed physicians. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our affiliated professional contractors usually enter into employment agreements with our affiliated physicians. Certain of our employment
agreements can be terminated without cause by any party upon prior written notice. In addition, substantially all of our affiliated physicians have agreed not to compete within a specified geographic area for a certain period after termination of
employment. The law governing <FONT STYLE="white-space:nowrap">non-compete</FONT> agreements and other forms of restrictive covenants varies from state to state. Although we believe that the <FONT STYLE="white-space:nowrap">non-competition</FONT>
and other restrictive covenants applicable to our affiliated physicians are reasonable in scope and duration and therefore enforceable under applicable state law, courts and arbitrators in some states may be reluctant to enforce <FONT
STYLE="white-space:nowrap">non-compete</FONT> agreements and restrictive covenants against physicians. In addition, we may incur significant legal fees to pursue enforcement of such agreements and restrictive covenants. Our affiliated physicians or
other clinicians may leave our affiliated practices for a variety of reasons, including in order to provide services for other types of healthcare providers, such as teaching, research and government institutions, hospitals and health systems and
other practice groups. If a substantial number of our affiliated physicians or other clinicians leave our affiliated practices, we could incur significant legal fees to pursue enforcement of certain covenants within employment agreements or if our
affiliated professional contractors are unable to enforce the <FONT STYLE="white-space:nowrap">non-competition</FONT> covenants in the employment agreements, our business, financial condition, results of operations and cash flows could be
materially, adversely affected. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Our treatment of certain physicians and other clinicians as independent contractors may be challenged by taxing
authorities or other governmental agencies. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Certain of our affiliated physicians and other clinicians are treated as independent
contractors, as opposed to employees, and, accordingly, we do not withhold federal income, state income, FICA, or other employment related taxes from these individuals&#146; compensation, make federal income, state income, FICA, or unemployment tax
or other related payments, provide workers&#146; compensation insurance or&nbsp;allow them to participate in the benefits and retirement programs available to our employees, or apply federal or state employee requirements. The classification of
physicians and other clinicians as independent contractors depends on the facts and circumstances of the relationship. Additionally, under current federal tax law, a safe harbor from reclassification, and consequently retroactive taxes and
penalties, is available if our current treatment is consistent with a long-standing practice of a significant segment of our industry and if we meet certain other requirements. In the past, there have been proposals to eliminate the safe harbor, and
similar proposals may happen again in the future. If taxing authorities or other governmental agencies are successful in challenging our treatment of these physicians and other clinicians as independent contractors, and we do not prevail in
demonstrating the applicability of the safe harbor to our operations or the safe harbor is eliminated, we may be required to pay retroactive employment taxes and penalties and reclassify such independent contractors to employees. In addition, such
independent contractors could claim retroactive entitlements to various employee benefits. Any of these actions would increase our costs related to these physicians and our business, financial condition, results of operations and cash flows could be
materially, adversely affected. </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">38 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>We may be subject to medical malpractice and other lawsuits not covered by insurance. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our business entails an inherent risk of claims of medical malpractice against our affiliated physicians and us. We may also be subject to
other lawsuits which may involve large claims and significant defense costs. Although we currently maintain liability insurance coverage intended to cover professional liability and other claims, there can be no assurance that our insurance coverage
will be adequate to cover liabilities arising out of claims asserted against us where the outcomes of such claims are unfavorable to us. Generally, we self-insure our liabilities to pay retention amounts for professional liability matters through a
wholly owned captive insurance subsidiary. Liabilities in excess of our insurance coverage, including coverage for professional liability and other claims, could have a material adverse effect on our business, financial condition, results of
operations, cash flows and the trading price of our securities. See Item 1. Business&#151;&#147;Other Legal Proceedings&#148; and&#151;&#147;Professional and General Liability Coverage.&#148; </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>The reserves that we have established related to our professional liability losses are subject to inherent uncertainties and if a deficiency is determined
this may lead to a reduction in our net earnings. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have established reserves for losses and related expenses that represent
estimates involving actuarial projections. These actuarial projections are developed at a given point in time and represent our expectations of the ultimate resolution and administration of costs of losses incurred with respect to professional
liability risks for the amount of risk retained by us. Insurance reserves are inherently subject to uncertainty. Our reserve estimates are based on actuarial valuations using historical claims, demographic factors, industry trends, severity and
exposure factors and other actuarial assumptions. The estimates of projected ultimate losses are developed at least annually. Our reserves could be significantly affected should current and future occurrences differ from historical claim trends and
expectations. While claims are monitored closely when estimating reserves, the complexity of the claims and wide range of potential outcomes often hamper timely adjustments to the assumptions used in these estimates. Actual losses and related
expenses may deviate, perhaps substantially, from the reserve estimates reflected in our financial statements. If our estimated reserves are determined to be inadequate, we will be required to increase reserves at the time the deficiency is
determined. See Item 7. Management&#146;s Discussion and Analysis of Financial Condition and Results of Operations&#151;&#147;Application of Critical Accounting Policies and Estimates&#151;Professional Liability Coverage.&#148; </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>We may <FONT STYLE="white-space:nowrap">write-off</FONT> intangible assets, such as goodwill. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The carrying value of our intangible assets, which consists primarily of goodwill related to our acquisitions, is subject to testing at least
annually, and more frequently if impairment indicators exist. Under current accounting standards, goodwill is tested for impairment on an annual basis and we may be subject to impairment losses as circumstances change after an acquisition. If we
record an impairment loss related to our goodwill, it could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>We may not effectively manage our growth. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have experienced significant growth in our business, including growth outside of our core physician specialties. Growth in the number of our
employees and affiliated physicians in recent years places significant demands on our financial, operational and management resources. Continued growth may impair our ability to provide our services efficiently and to manage our employees
adequately. While we are taking steps to manage our growth, our future results of operations could be materially, adversely affected if we are unable to do so effectively. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Our quarterly results will likely fluctuate from period to period. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have historically experienced and expect to continue to experience quarterly fluctuations in net revenue and net income. For example, we
typically experience negative cash flow from operations in the first quarter of </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">39 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
each year, principally as a result of bonus payments to affiliated physicians as well as discretionary matching contributions for participants in our qualified contributory savings plans. In
addition, a significant number of our employees and associated professional contractors (primarily affiliated physicians) exceed the level of taxable wages for social security contributions during the first and second quarters. As a result, we incur
a significantly higher payroll tax burden and our net income is lower during those quarters. Moreover, a lower number of calendar days are present in the first and second quarters of the year as compared to the remainder of the year. Because we
provide services in the NICU on a <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">24-hours-a-day</FONT></FONT></FONT> basis, 365 days a year, any reduction in service days will have a corresponding
reduction in net revenue. In addition, any reduction in office days in our office-based practices or business days in our anesthesia practices will also have a corresponding reduction in net revenue. We also have significant fixed operating costs,
including costs for our affiliated physicians, and as a result, are highly dependent on patient volume and capacity utilization of our affiliated physicians to sustain profitability. Quarterly results may also be impacted by the timing of
acquisitions and any fluctuation in patient volume. As a result, our results of operations for any quarter are not indicative of results of operations for any future period or full fiscal year. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Our current indebtedness and any future indebtedness could adversely affect us by reducing our flexibility to respond to changing business and economic
conditions and expose us to interest rate risk to the extent of any variable rate debt. In addition, a certain portion of our interest expense may not be deductible. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As of December&nbsp;31, 2018, our total indebtedness was $2.0&nbsp;billion, of which $739.5&nbsp;million was exposed to variable interest
rates. We also had $1.3&nbsp;billion of additional borrowing capacity under our revolving line of credit which was subject to a variable interest rate. Other debt we incur also could be variable rate debt. In addition, the Tax Cuts and Jobs Act of
2017 places certain limitations on the deductibility of interest expense at a percentage of taxable income. If interest rates increase, our variable rate debt will create higher debt service requirements, and if interest expense increases beyond a
specified percentage of taxable income, a portion of that interest expense may not be deductible for income tax purposes, which could adversely affect our results of operations and cash flows. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have limited restrictions on incurring substantial additional indebtedness in the future. Our current indebtedness and any future increases
in leverage could have adverse consequences on us, including: </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">a substantial portion of our cash flow from operations will be required to service interest and principal
payments on our debt and will not be available for operations, working capital, capital expenditures, expansion, acquisitions, dividends or general corporate or other purposes; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">our ability to obtain additional financing in the future may be impaired; </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">we may be more highly leveraged than our competitors, which may place us at a competitive disadvantage;
</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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">our flexibility in planning for, or reacting to, changes in our business and industry may be limited; 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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">we may be more vulnerable in the event of a downturn in our business, our industry or the economy in general.
</P></TD></TR></TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our ability to make payments on and to refinance our debt will depend on our ability to generate cash in the future.
This, to a certain extent, is subject to general economic, business, financial, competitive, legislative, regulatory, and other factors that are beyond our control. We cannot assure you that our business will generate sufficient cash flow from
operations or that future borrowings will be available under our revolving line of credit in an amount sufficient to enable us to pay our debt or to fund our other liquidity needs. We may need to refinance all or a portion of our debt on or before
maturity. We cannot assure you that we will be able to refinance any of our debt, including our revolving line of credit and senior notes, on commercially reasonable terms or at all. </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">40 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Servicing our debt requires a significant amount of cash. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our ability to make scheduled payments on or to refinance our debt obligations depends on our financial condition and operating performance,
which is subject to prevailing economic and competitive conditions and to certain financial, business, and other factors. We may not be able to maintain a level of cash flows from operating activities sufficient to permit us to pay the principal and
interest on our indebtedness. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">If our cash flows and capital resources are insufficient to fund our debt service requirements, we may be
forced to reduce or delay acquisitions or other investments, or to seek additional capital, or restructure or refinance our indebtedness. Our ability to restructure or refinance our debt will depend on the condition of the capital markets and our
financial condition at such time. In addition, any failure to make payments of interest and principal on our outstanding indebtedness on a timely basis would likely result in other defaults, disrupt our operations and cause a reduction of our credit
rating, which could further harm our ability to finance or refinance our obligations and business operations. These alternative measures may not be successful and may not permit us to meet our scheduled debt service obligations. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>The value of our common stock may fluctuate. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">There has been significant volatility in the market price of securities of healthcare companies generally that we believe in many cases has
been unrelated to operating performance. In addition, we believe that certain factors, such as actual and potential legislative and regulatory developments, including announced regulatory investigations, quarterly fluctuations in our actual or
anticipated results of operations, lower revenue or earnings than those anticipated by securities analysts, not meeting publicly announced expectations, and general economic and financial market conditions, could cause the price of our common stock
to fluctuate substantially. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>We may not be able to collect reimbursements for our services from third-party payors. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">A significant portion of our net revenue is derived from reimbursements from various third-party payors, including GHC Programs, private
insurance plans and managed care plans, for services provided by our affiliated professional contractors. We are responsible for submitting reimbursement requests to these payors and collecting the reimbursements, and we assume the financial risks
relating to uncollectible and delayed reimbursements. In the current healthcare environment, payors continue their efforts to control expenditures for healthcare, including revisions to coverage and reimbursement policies. Due to the nature of our
business and our participation in government-funded and private reimbursement programs, we are involved from time to time in inquiries, reviews, audits and investigations by governmental agencies and private payors of our business practices,
including assessments of our compliance with coding, billing and documentation requirements. We may be required to repay these agencies or private payors if a finding is made that we were incorrectly reimbursed, or we may become involved in disputes
with payors and could be subjected to <FONT STYLE="white-space:nowrap">pre-payment</FONT> and post-payment reviews, which can be time-consuming and result in <FONT STYLE="white-space:nowrap">non-payment</FONT> or delayed payment for the services we
provide. We may also experience difficulties in collecting reimbursements because third-party payors may seek to reduce or delay reimbursements to which we are entitled for services that our affiliated physicians have provided or they experience
administrative issues that result in a delay in reimbursements. In addition, GHC Programs may deny our application to become a participating provider that could cause us to not be able to provide services to patients or prohibit us from billing for
such services. If we are not reimbursed fully and in a timely manner for such services or there is a finding that we were incorrectly reimbursed, our revenue, cash flows and financial condition could be materially, adversely affected. In addition,
we may choose to challenge certain GHC reimbursement decisions through administrative appeal mechanisms. Currently, many of those appeal pathways are backlogged and slow to provide resolution, further affecting our ability to collect reimbursement
for services rendered. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, adverse economic conditions could affect the timeliness and amounts received from our third-party and
government payors which would impact our short-term liquidity needs. </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">41 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Hospitals or other customers may terminate their agreements with us, our physicians may lose the ability to
provide services in hospitals or administrative fees paid to us by hospitals may be reduced. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our net revenue is derived primarily from
<FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">fee-for-service</FONT></FONT> billings for patient care and other services provided by our affiliated physicians and from administrative fees paid to us by hospitals. See Item 1.
Business&#151;&#147;Relationships with Our Partners&#151;Hospitals.&#148; Our hospital partners or other customers may cancel or not renew their contracts with us, may reduce or eliminate our administrative fees in the future, or refuse to pay us
our administrative fees if we fail to honor the terms of our agreement or fail to meet certain performance metrics under those agreements. Further, consolidation of hospitals, health care systems or other customers could adversely affect our ability
to negotiate with these entities. Adverse economic conditions, including decreased federal and state funding to hospitals, could influence future actions of our hospital partners or other customers. To the extent that our arrangements with our
hospital partners or other customers are canceled, or are not renewed or replaced with other arrangements having at least as favorable terms, our business, financial condition and results of operations could be adversely affected. In addition, to
the extent our affiliated physicians lose their privileges in hospitals or hospitals enter into arrangements with or employ other physicians, including our existing affiliated physicians, our business, financial condition, results of operations and
cash flows could be materially, adversely affected. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Hospitals could limit our ability to use our management information systems in our units by
requiring us to use their own management information systems. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our management information systems, including BabySteps<SUP
STYLE="font-size:85%; vertical-align:top">&reg;</SUP> and the MEDNAX Qualified Clinical Data Registry are used to support our <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">day-to-day</FONT></FONT> operations and ongoing clinical
research and business analysis. If a hospital prohibits us from using our own management information systems, it may interrupt the efficient operation of our information systems which, in turn, may limit our ability to operate important aspects of
our business, including billing and reimbursement as well as research and education initiatives. This inability to use our management information systems at hospital locations may have a material adverse effect on our business, financial condition,
results of operations and cash flows. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Our industry is highly competitive. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The healthcare industry is highly competitive and subject to continual changes in the methods by which services are provided and the manner in
which healthcare providers are selected and compensated. Because our operations consist primarily of physician services provided within hospital-based units, we compete with other healthcare services companies and physician groups for contracts with
hospitals to provide our services to patients. We also face competition from hospitals themselves to provide our services. In addition, we face competition from other services companies in our teleradiology business and management services
organization. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Further, consolidation within the healthcare industry could strengthen certain competitors that provide services to
hospitals and other customers. Companies in other healthcare industry segments, some of which have greater financial and other resources than ours, may become competitors in providing neonatal, anesthesia, maternal-fetal, radiology or other
pediatric subspecialty care. Additionally, we face competition from healthcare-focused and other private equity firms. We may not be able to continue to compete effectively in this industry, additional competitors may enter metropolitan areas where
we operate, and this increased competition may have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Unfavorable changes or conditions could occur in the states where our operations are concentrated. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">A majority of our net revenue in 2018 was generated by our operations in five states. In particular, Texas accounted for approximately 20% of
our net revenue in 2018. See Item 1. Business&#151;&#147;Geographic Coverage.&#148; Adverse changes or conditions affecting these particular states, such as healthcare reforms, changes in laws and </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">42 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
regulations, reduced Medicaid eligibility or reimbursements and government investigations, economic conditions, weather conditions, and natural disasters may have a material adverse effect on our
business, financial condition, results of operations, cash flows and the trading price of our securities. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>We are dependent upon our key management
personnel for our future success. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our success depends to a significant extent on the continued contributions of our key management
personnel, including our Chief Executive Officer, Roger J. Medel, M.D., for the management of our business and implementation of our business strategy. The loss of Dr.&nbsp;Medel or other key management personnel could have a material adverse effect
on our business, financial condition, results of operations, cash flows and the trading price of our securities. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>We are subject to litigation risks.
</B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">From time to time, we are involved in various litigation matters and claims, including regulatory proceedings, administrative
proceedings, governmental investigations, and contract disputes, as they relate to our services and business. We may face potential claims or liability for, among other things, breach of contract, defamation, libel, fraud or negligence. Our
contracts with hospitals generally require us to indemnify them and their affiliates for losses resulting from the negligence of our affiliated physicians and other clinicians. We may also face employment-related litigation, including claims of age
discrimination,&nbsp;sexual harassment, gender discrimination, immigration violations, or other local, state, and federal labor law violations. Because of the uncertain nature of litigation and insurance coverage decisions, the outcome of such
actions and proceedings cannot be predicted with certainty and an unfavorable resolution of one or more of them could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our
securities. In addition, legal fees and costs associated with prosecuting and defending litigation matters could have a material adverse effect on our business, financial condition, results of operation and the trading price of our securities. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>If our shareholders do not approve the issuance of additional shares of common stock under our Amended and Restated 2008 Incentive Compensation Plan, as
amended (the &#147;Incentive Plan&#148;), or a new incentive plan, we may not have sufficient shares of common stock under the Incentive Plan to implement our compensation plans, our ability to attract and retain talent may be hindered, and our cash
flows may be reduced. </I></B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have historically used restricted stock, stock options and other equity awards as a component of our
employee and director compensation programs to align our directors&#146;, officers&#146; and employees&#146; interests with the interests of our shareholders, encourage employee retention and provide competitive compensation packages. As of February
13, 2019, there were approximately 50,600 shares of common stock available for issuance under the Incentive Plan. We intend to seek shareholder approval at our upcoming annual meeting of shareholders for the issuance of additional shares of common
stock under the Incentive Plan or a new incentive plan. If we do not obtain shareholder approval to increase the number of shares of common stock available for issuance under the Incentive Plan or a new incentive plan, we may be required to use a
greater percentage of our cash flow for incentive, retention, and hiring payments, which would reduce the cash flow available for other purposes and could have a material adverse effect on our ability to attract and retain talent necessary to run
our business. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Provisions of our articles and bylaws could deter takeover attempts, but our business could be negatively affected as a result of
shareholder activism. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our Amended and Restated Articles of Incorporation, as amended, authorize our Board of Directors to issue up to
1,000,000 shares of undesignated preferred stock and to determine the powers, preferences and rights of these shares without shareholder approval. This preferred stock could be issued with voting, liquidation, dividend and other rights superior to
those of the holders of common stock. The issuance of preferred stock under some circumstances could have the effect of delaying, deferring or preventing a change in control. In addition, </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">43 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
provisions in our Amended and Restated Articles of Incorporation, as amended, and Bylaws, including those relating to calling shareholder meetings, taking action by written consent and other
matters, could render it more difficult or discourage an attempt to obtain control of MEDNAX through a proxy contest or consent solicitation, however, there is no assurance that these provisions would have such an effect. These provisions could
limit the price that some investors might be willing to pay in the future for our shares of common stock. Notwithstanding these provisions, we could become the target of activist shareholders who acquire ownership positions in our common stock and
seek to influence our company. Responding to actions by activist shareholders can be costly and time-consuming, disrupt our business and divert the attention of our Board of Directors, management and employees. Additionally, perceived uncertainties
as to our future direction as a result of shareholder activism may lead to the perception of a change in the direction of our business or other instability, which may be exploited by our competitors, cause concern to our current or potential
customers and acquisition candidates, and make it more difficult for us to attract and retain qualified personnel, which could have a material adverse effect on our business, financial condition, results of operations, and cash flows and the trading
prices of our securities. In addition, the trading prices of our securities may experience periods of increased volatility as a result of shareholder activism. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_3"></A>ITEM&nbsp;1B.</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>UNRESOLVED STAFF COMMENTS </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">None. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_4"></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>PROPERTIES </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our two corporate office buildings, which we own, are located in Sunrise, Florida and contain 260,000 square feet of office space. We also own
an office building used for our management services organization call center operations covering 175,000 square feet in Cascade Falls, Michigan. We also lease space in hospitals and other facilities for our business and medical offices, and other
needs. See Note 16 to the Consolidated Financial Statements in this Form <FONT STYLE="white-space:nowrap">10-K,</FONT> which is incorporated herein by reference. We believe that our facilities and the equipment used in our business are in good
condition, in all material respects, and sufficient for our present needs. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_5"></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>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">The information required by this Item is included in and incorporated herein by reference to Item 1. Business of this Form <FONT
STYLE="white-space:nowrap">10-K</FONT> under &#147;Government Investigations&#148; and &#147;Other Legal Proceedings.&#148; </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_6"></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>MINE SAFETY DISCLOSURES </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Not applicable </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">44 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx671465_7"></A><A NAME="tx671465_6a"></A>PART II </B></P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="9%" VALIGN="top" ALIGN="left"><B>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>MARKET FOR REGISTRANT&#146;S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY
SECURITIES </B></P></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Common Stock </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our common stock is traded on the New York Stock Exchange (the &#147;NYSE&#148;) under the symbol &#147;MD.&#148; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As of February&nbsp;7, 2019, we had 326 holders of record of our common stock, and the closing sales price on that date for our common stock
was $36.32 per share. We believe that the number of beneficial owners of our common stock is greater than the number of record holders because a significant number of shares of our common stock is held through brokerage firms in &#147;street
name.&#148; </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Dividend Policy </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We did
not declare or pay any cash dividends on our common stock in 2018, 2017, or 2016, nor do we currently intend to declare or pay any cash dividends in the future. The payment of any future dividends will be at the discretion of our Board of Directors
and will depend upon, among other things, future earnings, results of operations, capital requirements, our general financial condition, general business conditions and contractual restrictions on payment of dividends, if any, as well as such other
factors as our Board of Directors may deem relevant. Our credit agreement (the &#147;Credit Agreement&#148;) imposes certain limitations on our ability to declare and pay cash dividends. See Item 7. Management&#146;s Discussion and Analysis of
Financial Condition and Results of Operations&#151;&#147;Liquidity and Capital Resources.&#148; </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">45 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Performance Graph </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following graph compares the cumulative total shareholder return on $100 invested on December&nbsp;31, 2013 in our common stock against the
cumulative total return of the S&amp;P 500 Index, S&amp;P 600 Health Care Index, and the NYSE Composite Index. The returns are calculated assuming reinvestment of dividends. The graph covers the period from December&nbsp;31, 2013 through
December&nbsp;31, 2018. The stock price performance included in the graph is not necessarily indicative of future stock price performance. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><I>The performance graph shall not be deemed incorporated by reference by any general statement incorporating by reference this annual report
into any filing under the Securities Act of 1933 or the Securities Exchange Act of 1934, except to the extent that we specifically incorporate this information by reference, and shall not otherwise be deemed filed under such acts. </I></P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P> <P STYLE="margin-top:0pt;margin-bottom:0pt">


<IMG SRC="g671465g65b88.jpg" ALT="LOGO">
 </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="52%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; 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>Base&nbsp;Period</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="18" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ending</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom" NOWRAP> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-bottom:1.00pt solid #000000; display:table-cell; font-size:8pt; font-family:Times New Roman; "><B>Company/Index</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2013</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2014</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2015</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2017</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<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></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">MEDNAX, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">100.00</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">123.85</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">134.25</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">124.88</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">100.11</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">61.82</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">S&amp;P 500 Index</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">100.00</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">111.39</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">110.58</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">121.13</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">144.65</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">135.63</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">S&amp;P 600 Health Care</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">100.00</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">110.92</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">133.53</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">136.13</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">183.06</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">200.95</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">NYSE Composite Index</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">100.00</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">104.22</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">97.53</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">106.31</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">123.16</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">109.37</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">46 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Issuer Purchases of Equity Securities </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the three months ended December&nbsp;31, 2018, 1,662,616 shares of our common stock were delivered to us in connection with the final
settlement of our August 2018 accelerated share repurchase program. </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="44%"></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>
<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" 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>Repurchased</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<BR>Price&nbsp;Paid<BR>per Share</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Total&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 (a)</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">October&nbsp;1 &#150; October&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">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"> &#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(a</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">November&nbsp;1 &#150; November&nbsp;30, 2018</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(a</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">December&nbsp;1 &#150; December&nbsp;31, 2018</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,662,616</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">42.47</TD>
<TD NOWRAP VALIGN="bottom">(b)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,886,480</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;</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">1,662,616</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">42.47</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,886,480</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 repurchase 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 and is estimated to be approximately
1.3&nbsp;million shares for 2019. The share repurchases under that program for 2018 were completed during the second quarter of 2018. Our August 2018 repurchase program allows us to repurchase up to an additional $500.0&nbsp;million of shares of our
common stock, of which we have repurchased $250.0&nbsp;million, inclusive of the shares delivered to us in the table above representing the final settlement of our accelerated share repurchase program entered into on August&nbsp;31, 2018.
</P></TD></TR></TABLE>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">(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">Represents the average price paid per share for the $250.0&nbsp;million accelerated share repurchase program
entered into on August&nbsp;31, 2018. </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:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Recent Sales of Unregistered Equity Securities </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the three months ended December&nbsp;31, 2018, we did not sell any unregistered shares of our equity securities. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Equity Compensation Plans </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Information
regarding equity compensation plans is set forth in Item 12 of this Form <FONT STYLE="white-space:nowrap">10-K</FONT> and is incorporated herein by reference. </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">47 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_8"></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>SELECTED FINANCIAL DATA </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 table includes selected consolidated financial data set forth as of and for each of the five years in the period ended
December&nbsp;31, 2018. The balance sheet data at December&nbsp;31, 2018 and 2017, and the income statement data for the years ended December&nbsp;31, 2018, 2017 and 2016, have been derived from the Consolidated Financial Statements included in this
Form <FONT STYLE="white-space:nowrap">10-K.</FONT> This selected financial data should be read in conjunction with &#147;Management&#146;s Discussion and Analysis of Financial Condition and Results of Operations,&#148; and our Consolidated Financial
Statements and the related notes included in Items 7 and 8, respectively, of this Form <FONT STYLE="white-space:nowrap">10-K</FONT> (in thousands, except per share and other operating data). </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:9pt" ALIGN="center">


<TR>
<TD WIDTH="55%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="18" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2015</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2014</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman"><B>Consolidated Income Statement Data:</B></P></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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net revenue (1)</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,647,123</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,458,312</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,183,159</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,779,996</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,438,913</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></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 expenses:</P></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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Practice salaries and benefits</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,535,588</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,337,734</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,031,220</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,753,505</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,543,395</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Practice supplies and other operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">122,028</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">120,518</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">118,416</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">98,480</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,002</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">General and administrative expenses</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">432,378</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">417,105</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">372,572</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">305,915</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">247,527</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Depreciation and amortization</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">111,281</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">102,879</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,264</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">64,228</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">45,990</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Total operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,201,275</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,978,236</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,611,472</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,222,128</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,925,914</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Income from operations</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">445,848</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">480,076</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">571,687</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">557,868</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">512,999</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Investment and other income</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,935</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,953</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,019</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,844</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,728</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Interest expense</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(88,769</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(74,559</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(63,092</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(23,110</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(8,891</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Equity in earnings of unconsolidated affiliates</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6,825</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">952</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,185</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,127</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,780</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Total <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(77,009</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(69,654</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(57,888</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(18,139</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(4,383</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Income before income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">368,839</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">410,422</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">513,799</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">539,729</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">508,616</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Income tax provision</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(100,210</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(90,050</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(189,203</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(204,038</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(191,413</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">268,629</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">324,596</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">335,691</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">317,203</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:9pt; font-family:Times New Roman">Net loss attributable to noncontrolling interests</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">318</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">629</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">78</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">268,629</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">324,914</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">336,320</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">317,281</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman"><B>Per Common and Common Equivalent Share Data:</B></P></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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc.:</P></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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 2.95</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 3.47</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 3.52</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 3.61</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 3.22</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 2.93</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 3.45</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 3.49</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 3.58</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 3.18</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Weighted average common shares:</P></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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">91,104</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,431</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,422</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,077</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">98,588</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">91,606</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,958</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,109</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,960</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">99,887</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman"><B>Other Operating Data:</B></P></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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Number of physicians at end of year</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,214</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,083</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,617</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,240</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,625</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Number of births</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">793,918</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">808,465</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">807,285</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">803,311</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">799,868</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">NICU admissions</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">113,485</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">112,965</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">112,184</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">111,407</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">108,978</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">NICU patient days</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,977,516</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,990,521</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,977,204</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,960,768</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,919,579</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Number of anesthesia cases</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,844,451</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,924,952</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,827,194</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,533,089</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,284,149</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Number of radiology studies (2)</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">11,505,524</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10,166,227</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,755,853</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,317,309</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman"><B>Consolidated Balance Sheet Data:</B></P></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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash and cash equivalents</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">36,745</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">60,200</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">55,698</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">51,572</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">47,928</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Working capital</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">157,216</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">95,810</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">138,179</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">98,998</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">50,779</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Total assets</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,934,911</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,867,278</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,339,400</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,547,214</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,608,248</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Total liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,847,027</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,800,824</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,578,633</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,109,368</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,342,682</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Borrowings under credit facility</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">739,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,110,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">963,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">533,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">568,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Senior notes outstanding</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,250,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">750,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">750,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">750,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Total equity</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,087,884</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,066,454</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,760,767</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,437,846</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,265,566</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:9pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="3%" VALIGN="top" ALIGN="left">(1)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:9pt; font-family:Times New Roman; " ALIGN="left">The increase in net revenue related to acquisitions was $102.1&nbsp;million, $256.0&nbsp;million,
$356.4&nbsp;million, $345.7&nbsp;million, and $205.4&nbsp;million for the years ended December&nbsp;31, 2018, 2017, 2016, 2015, and 2014, respectively. </P></TD></TR></TABLE>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:9pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="3%" VALIGN="top" ALIGN="left">(2)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:9pt; font-family:Times New Roman; " ALIGN="left">Represents estimated annualized number of studies for years in which acquisitions took place.
</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">48 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="9%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_9"></A>ITEM&nbsp;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>MANAGEMENT&#146;S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS 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 our Consolidated Financial Statements and the related notes included in Item&nbsp;8 of this Form <FONT
STYLE="white-space:nowrap">10-K.</FONT> This discussion contains forward-looking statements. Please see the explanatory note concerning &#147;Forward-Looking Statements&#148; preceding Part I of this Form <FONT STYLE="white-space:nowrap">10-K</FONT>
and Item 1A. Risk Factors for a discussion of the uncertainties, risks and assumptions associated with these forward-looking statements. The operating results for the periods presented were not significantly affected by inflation. </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, radiology and teleradiology, maternal-fetal, pediatric cardiology and other pediatric subspecialty care in 39 states and Puerto Rico. At December&nbsp;31, 2018, our national network comprised over
4,210 affiliated physicians, including 1,270 physicians who provide neonatal clinical care, primarily within hospital-based NICUs, to babies born prematurely or with medical complications. We have 1,315 affiliated physicians who provide anesthesia
care to patients in connection with surgical and other procedures, as well as pain management. In addition, we have 365 affiliated physicians who provide maternal-fetal and obstetrical medical care to expectant mothers experiencing complicated
pregnancies primarily in areas where our affiliated neonatal physicians practice. Our network also includes other pediatric subspecialists, including 190 physicians providing pediatric intensive care, 110 physicians providing pediatric cardiology
care, 140 physicians providing hospital-based pediatric care, 25 physicians providing pediatric surgical care, and 10 physicians providing pediatric ear, nose and throat and pediatric ophthalmology services. MEDNAX also provides radiology services
including diagnostic imaging and interventional radiology, through a network of more than 355 affiliated physicians, as well as teleradiology services in all 50 states, the District of Columbia and Puerto Rico through a network of over 430
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 2018, we completed nine physician group practice acquisitions, including five radiology practices, two neonatology practices and two
pediatric subspecialty practices. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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. We believe that we bring a
unique value proposition to radiology physician groups, in that we can provide practice management support and a technology platform enabling radiology to be practiced at a national level, as well as teleradiology capabilities that can enhance their
efficiency, provide subspecialty access and help them to grow strategically and remain competitive while meeting the demands of their hospital partners, third-party payors and regulatory bodies. In addition, 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. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Shared Services 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 shared services functions and our operational
infrastructure, with a goal of generating improvements in our general and administrative expenses and our operational infrastructure. In our shared services departments, we are focused on </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">49 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
improving processes, using our resources more efficiently and utilizing our scale more effectively to improve cost and service performance across 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 currently intend to make a series of information-technology and other investments to improve processes and performance across our enterprise, using both internal and external
resources. 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:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Senior Notes </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In November 2018, we completed a private offering of $500.0&nbsp;million aggregate principal amount of 6.25% senior unsecured notes due 2027
(the &#147;2027 Notes&#148;). Our obligations under the 2027 Notes are guaranteed on an unsecured senior basis by the same subsidiaries and affiliated professional contractors that guarantee our Credit Agreement. Interest on the 2027 Notes accrues
at the rate of 6.25% per annum and is payable semi-annually in arrears on January&nbsp;15 and July&nbsp;15, beginning on January&nbsp;15, 2019. We used the net proceeds of approximately $492.5&nbsp;million from the issuance of the 2027 Notes to
repay a portion of the indebtedness outstanding under our Credit Agreement. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Common Stock Repurchase Programs </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. Shares repurchased by us during the second quarter of 2018 completed the repurchases under the program with respect to issuances of shares under our equity compensation programs during 2018. In August 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. As part of this repurchase program, on August&nbsp;31, 2018, we entered into a $250&nbsp;million
uncollared accelerated share repurchase agreement with an investment bank that was completed in December 2018. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Under the share repurchase
programs described above, we repurchased approximately 7.0&nbsp;million shares of our common stock for approximately $302.2&nbsp;million during the year ended December&nbsp;31, 2018, 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 second quarter of 2018. </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. We currently intend to utilize a portion of our remaining $250&nbsp;million share repurchase authorization via open market purchases in the first quarter of 2019, however, 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 year ended December&nbsp;31, 2018, the
percentage of our patient service revenue being reimbursed under GHC Programs, </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">50 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
remained relatively consistent as compared to the year ended December&nbsp;31, 2017. If, however, economic conditions in the United States deteriorate, we could experience shifts toward GHC
Programs, and patient volumes could decline. Further, we could experience and have experienced shifts toward GHC Programs if changes occur in population demographics within geographic locations in which we provide services. We have also experienced,
and expect to continue to experience, a shift toward GHC Programs in anesthesia care. 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. See Item 1A. Risk Factors, in this Form <FONT
STYLE="white-space:nowrap">10-K</FONT> for additional discussion on the general economic conditions in the United States and recent developments in the healthcare industry that could affect our business. </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 flux and uncertainty.
In 2017, Congress unsuccessfully sought to replace substantial parts of the ACA with different mechanisms for facilitating insurance coverage in the commercial and Medicaid markets. Additionally, CMS has administratively revised a number of
provisions and may seek to advance additional significant changes through regulation, guidance and enforcement in the future. At the end of 2017, Congress repealed part of the ACA that required most individuals to purchase and maintain health
insurance or face a tax penalty. The 2018 <FONT STYLE="white-space:nowrap">mid-term</FONT> elections in November 2018 changed the balance of power in Congress and may change the direction of future health-related legislation. More recently, a
federal judge in Texas declared that key portions of the ACA were inconsistent with the United States Constitution and specifically that the ACA cannot stand on its own since Congress repealed the individual mandate. Several states are now engaged
in appealing this decision. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 and Congress, 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 </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">51 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
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:18pt; 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. The Medicare Access and CHIP Reauthorization Act
(&#147;MACRA&#148;) 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 requires 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 APMs, and physicians who are meaningful participants in APMs will receive bonus payments from Medicare pursuant to the law. MACRA also remains subject to review and potential modification by Congress, as well as shifting
regulatory requirements established by CMS. 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, 36 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, began in April 2013 and apply to mandatory and discretionary spending in the
years 2013 to 2027. 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>Geographic
Coverage </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During 2018, 2017 and 2016, approximately 52%, 51%, and 51%, respectively, of our net revenue was generated by operations in
our five largest states. During 2018, 2017, and 2016, our five largest states consisted of Texas, Florida, Tennessee, Georgia, and North Carolina. During 2018, 2017, and 2016, our operations in Texas accounted for approximately 20%, 19%, and 19%,
respectively, of our net revenue. </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">52 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Payor Mix </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We bill payors for professional services provided by our affiliated physicians to our patients based upon rates for specific services provided.
Our billed charges are substantially the same for all parties in a particular geographic area regardless of the party responsible for paying the bill for our services. We determine our net revenue based upon the difference between our gross fees for
services and our estimated ultimate collections from payors. Net revenue differs from gross fees due to (i)&nbsp;managed care payments at contracted rates, (ii)&nbsp;GHC Program reimbursements at government-established rates, (iii)&nbsp;various
reimbursement plans and negotiated reimbursements from other third-parties, and (iv)&nbsp;discounted and uncollectible accounts of <FONT STYLE="white-space:nowrap">private-pay</FONT> patients. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our payor mix is composed of contracted managed care, government, principally Medicare and Medicaid, other third-parties and <FONT
STYLE="white-space:nowrap">private-pay</FONT> patients. We benefit from the fact that most of the medical services provided in the NICU are classified as emergency services, a category typically classified as a covered service by managed care
payors. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following is a summary of our payor mix, expressed as a percentage of net revenue, exclusive of administrative fees and
revenue related to our <FONT STYLE="white-space:nowrap">non-practice</FONT> service offerings, for the periods indicated: </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Contracted managed care</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Government</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">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">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Other third-parties</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></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">2</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The payor mix shown in the table above is not necessarily representative of the amount of services provided to
patients covered under these plans. For example, the gross amount billed to patients covered under GHC Programs for the years ended December&nbsp;31, 2018, 2017 and 2016 represented approximately 55% of our total gross patient service revenue. These
percentages of gross revenue and the percentages of net revenue provided in the table above include the payor mix impact of acquisitions completed through December&nbsp;31, 2018. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Quarterly Results </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have historically
experienced and expect to continue to experience quarterly fluctuations in net revenue and net income. These fluctuations are primarily due to the following factors: </P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">There are fewer calendar days in the first and second quarters of the year, as compared to the third and fourth
quarters of the year. Because we provide services in NICUs on a <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">24-hours-a-day</FONT></FONT></FONT> basis, 365 days a year, any reduction in service
days will have a corresponding reduction in net revenue. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">The majority of physician services provided by our office-based and anesthesia practices consist of office visits
and scheduled procedures that occur during business hours. As a result, volumes at those practices fluctuate based on the number of business days in each calendar quarter. </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="5%">&nbsp;</TD>
<TD WIDTH="2%" VALIGN="top" ALIGN="left">&#149;</TD>
<TD WIDTH="1%" VALIGN="top">&nbsp;</TD>
<TD ALIGN="left" VALIGN="top"> <P ALIGN="left" STYLE=" margin-top:0pt ; margin-bottom:0pt; font-family:Times New Roman; font-size:10pt">A significant number of our employees and our associated professional contractors, primarily physicians, exceed
the level of taxable wages for social security during the first and second quarters of the year. As a result, we incur a significantly higher payroll tax burden and our net income is lower during those quarters. </P></TD></TR></TABLE>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have significant fixed operating costs, including physician compensation, and, as a result, are highly dependent on patient volume and
capacity utilization of our affiliated professional contractors to sustain profitability. Additionally, quarterly results may be affected by the timing of acquisitions and fluctuations in </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">53 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
patient volume. As a result, the operating results for any quarter are not necessarily indicative of results for any future period or for the full year. Our unaudited quarterly results are
presented in further detail in Note 17 to our Consolidated Financial Statements in this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Application
of Critical Accounting Policies and Estimates </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The preparation of financial statements in conformity with accounting principles
generally accepted in the United States (&#147;GAAP&#148;) requires estimates and assumptions that affect the reporting of assets, liabilities, revenue and expenses, and the disclosure of contingent assets and liabilities. Note 2 to our Consolidated
Financial Statements provides a summary of our significant accounting policies, which are all in accordance with GAAP. Certain of our accounting policies are critical to understanding our Consolidated Financial Statements because their application
requires management to make assumptions about future results and depends to a large extent on management&#146;s judgment, because past results have fluctuated and are expected to continue to do so in the future. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We believe that the application of the accounting policies described in the following paragraphs is highly dependent on critical estimates and
assumptions that are inherently uncertain and highly susceptible to change. For all of these policies, we caution that future events rarely develop exactly as estimated, and the best estimates routinely require adjustment. On an ongoing basis, we
evaluate our estimates and assumptions, including those discussed below. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Revenue Recognition </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We recognize patient service revenue at the time services are provided by our affiliated physicians. Our performance obligations relate to the
delivery of services to patients and 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 our patient service revenue is reimbursed by GHC Programs and third-party insurance payors. Payments for services rendered to our patients are generally less than billed charges. We monitor our revenue and receivables from these
sources and record an estimated contractual allowance to properly account for the anticipated differences between billed and reimbursed amounts. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; 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. Management
estimates allowances for contractual adjustments and uncollectibles on accounts receivable based upon historical experience and other factors, including days sales outstanding (&#147;DSO&#148;) for accounts receivable, evaluation of expected
adjustments and delinquency rates, past adjustments and collection experience in relation to amounts billed, an aging of accounts receivable, current contract and reimbursement terms, changes in payor mix and other relevant information. Collection
of patient service revenue we expect to receive is normally a function of providing complete and correct billing information to the GHC 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. Contractual adjustments result from the difference between the physician rates for services performed and the reimbursements by GHC Programs and third-party insurance payors for such services. The
evaluation of these historical and other factors involves complex, subjective judgments. On a routine basis, we compare our cash collections to recorded net patient service revenue and evaluate our historical allowance for contractual adjustments
and uncollectibles based upon the ultimate resolution of the accounts receivable balance. These procedures are completed regularly in order to monitor our process of establishing appropriate reserves for contractual adjustments. We have not recorded
any material adjustments to prior period contractual adjustments and uncollectibles in the years ended December&nbsp;31, 2018, 2017 or 2016. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Some of our agreements require hospitals to pay us administrative fees. Some agreements provide for fees if the hospital does not generate
sufficient patient volume in order to guarantee that we receive a specified minimum revenue level. We also receive fees from hospitals for administrative services performed by our affiliated physicians providing medical director or other services at
the hospital. </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">54 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, we generate revenue through our 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:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">DSO is one of the key factors that we use to evaluate the condition of our accounts receivable and the related allowances for
contractual adjustments and uncollectibles. DSO reflects the timeliness of cash collections on billed revenue and the level of reserves on outstanding accounts receivable. Any significant change in our DSO results in additional analyses of
outstanding accounts receivable and the associated reserves. We calculate our DSO using a three-month rolling average of net revenue. Our net revenue, net income and operating cash flows may be materially and adversely affected if actual adjustments
and uncollectibles exceed management&#146;s estimated provisions as a result of changes in these factors. As of December&nbsp;31, 2018, our DSO was 53.5 days. We had approximately $2.0&nbsp;billion in gross accounts receivable outstanding at
December&nbsp;31, 2018, and considering this outstanding balance, based on our historical experience, a reasonably likely change of 0.5% to 1.50% in our estimated collection rate would result in an impact to net revenue of $10.2&nbsp;million to
$30.5&nbsp;million. The impact of this change does not include adjustments that may be required as a result of audits, inquiries and investigations from government authorities and agencies and other third-party payors that may occur in the ordinary
course of business. See Note 16 to our Consolidated Financial Statements in this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Professional
Liability Coverage </I></B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We maintain professional liability insurance policies with third-party insurers generally on a claims-made
basis, subject to self-insured retention, exclusions and other restrictions. Our self-insured retention under our professional liability insurance program is maintained primarily through a wholly owned captive insurance subsidiary. We record
liabilities for self-insured amounts and claims incurred but not reported based on an actuarial valuation using historical loss information, claim emergence patterns and various actuarial assumptions. Liabilities for claims incurred but not reported
are not discounted. The average lag period from the date a claim is reported to the date it reaches final settlement is approximately four years, although the facts and circumstances of individual claims could result in lag periods that vary from
this average. Our actuarial assumptions incorporate multiple complex methodologies to determine the best liability estimate for claims incurred but not reported and the future development of known claims, including methodologies that focus on
industry trends, paid loss development, reported loss development and industry-based expected pure premiums. The most significant assumptions used in the estimation process include the use of loss development factors to determine the future
emergence of claim liabilities, the use of frequency and trend factors to estimate the impact of economic, judicial and social changes affecting claim costs, and assumptions regarding legal and other costs associated with the ultimate settlement of
claims. The key assumptions used in our actuarial valuations are subject to constant adjustments as a result of changes in our actual loss history and the movement of projected emergence patterns as claims develop. We evaluate the need for
professional liability insurance reserves in excess of amounts estimated in our actuarial valuations on a routine basis, and as of December&nbsp;31, 2018, based on our historical experience, a reasonably likely change of 4% to 8% in our estimates
would result in an increase or decrease to net income of $4.0&nbsp;million to $7.8&nbsp;million. However, because many factors can affect historical and future loss patterns, the determination of an appropriate professional liability reserve
involves complex, subjective judgment, and actual results may vary significantly from estimates. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Goodwill </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We record acquired assets, including identifiable intangible assets and liabilities at their respective fair values, recording to goodwill the
excess of purchase price over the fair value of the net assets acquired. We test goodwill for impairment at a reporting unit level on an annual basis, and more frequently if impairment indicators exist. We use a single-step quantitative test with
any goodwill impairment measured as the amount by </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">55 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
which a reporting unit&#146;s carrying value exceeds its fair value. We use income and market-based valuation approaches to determine the fair value of our reporting units. These approaches focus
on discounted cash flows and market multiples based on our market capitalization to derive the fair value of a reporting unit. We also consider the economic outlook for the healthcare services industry and various other factors during the testing
process, including hospital and physician contract changes, local market developments, changes in third-party payor payments, and other publicly available information. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Other Matters </I></B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Other significant
accounting policies, not involving the same level of measurement uncertainties as those discussed above, are nevertheless important to an understanding of our Consolidated Financial Statements. For example, our Consolidated Financial Statements are
presented on a consolidated basis with our affiliated professional contractors because we or one of our subsidiaries have entered into management agreements with our affiliated professional contractors meeting the &#147;controlling financial
interest&#148; criteria set forth in accounting guidance for consolidations. Our management agreements are further described in Note 2 to our Consolidated Financial Statements in this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> The policies
described in Note 2 often require difficult judgments on complex matters that are often subject to multiple sources of authoritative guidance and are frequently reexamined by accounting standards setters and regulators. See &#147;New Accounting
Pronouncements&#148; below for matters that may affect our accounting policies in the future. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><FONT STYLE="white-space:nowrap">Non-GAAP</FONT>
Measures </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 attributable to MEDNAX, Inc. before interest expense, income tax provision and depreciation and amortization. Prior to the fourth
quarter of 2017, we 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, we excluded these
items such that the interest expense adjustment represents only interest expense and conformed its historical EBITDA calculations accordingly. Adjusted earnings per common share (&#147;Adjusted EPS&#148;) consists of diluted net income attributable
to MEDNAX, Inc. per common and common equivalent share adjusted for amortization expense and stock-based compensation expense. Adjusted EPS for the year ended December&nbsp;31, 2017 excludes the net income tax benefit related to the reduction in our
net deferred tax liability resulting from the reduction in the corporate tax rate enacted in December 2017 under the Tax Cuts and Jobs Act of 2017. Additionally, Adjusted EPS for the year ended December&nbsp;31, 2016 excludes the net income tax
benefit resulting from the reversal of a liability for uncertain tax positions related to the favorable settlement of a tax matter during the third quarter of 2016. </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 attributable to MEDNAX, Inc. and diluted net income attributable
to MEDNAX, Inc. per common and common equivalent share, provide investors with useful supplemental information to compare and understand our underlying business trends and performance across reporting periods on a consistent basis. These measures
should be considered a supplement to, and not a substitute for, financial performance measures determined in accordance with GAAP. In addition, since these <FONT STYLE="white-space:nowrap">non-GAAP</FONT> measures are not determined in accordance
with GAAP, they are susceptible to varying calculations and may not be comparable to other similarly titled measures of other companies. </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 years ended December&nbsp;31,
2018, 2017 and 2016, 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 </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">56 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
www.mednax.com under the Investors tab. Our internet website and the information contained therein or connected thereto are not incorporated into or deemed a part of this Form <FONT
STYLE="white-space:nowrap">10-K.</FONT> </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="61%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">268,629</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">324,914</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">88,769</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">74,559</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">63,092</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">100,210</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">90,050</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">189,203</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">111,281</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">102,879</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,264</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">EBITDA</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">568,889</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">587,860</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">666,473</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="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="56%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="22" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">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">91,606</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">92,958</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5" ALIGN="center">93,109</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 attributable to MEDNAX, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">268,629</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2.93</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 3.45</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">324,914</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 3.49</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">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;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Amortization (net of tax of $19,780, $26,902 and $23,443)</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">53,020</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.58</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">42,079</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.45</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">36,873</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.39</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 $10,516, $11,534 and $13,216)</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">28,187</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.31</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">18,039</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.19</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20,784</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.22</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income tax benefits</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 VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(70,014</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(0.75</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(10,646</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(0.11</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;</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">Adjusted net income and diluted EPS</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">349,836</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.82</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">310,476</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.34</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">371,925</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.99</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;</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:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>RESULTS OF OPERATIONS </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following table sets forth, for the periods indicated, certain information related to our operations expressed as a percentage of our net
revenue: </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="72%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>&nbsp;&nbsp;2018&nbsp;&nbsp;</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>&nbsp;&nbsp;2017&nbsp;&nbsp;</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>&nbsp;&nbsp;2016&nbsp;&nbsp;</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">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100.0</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100.0</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100.0</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Operating expenses:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice salaries and benefits</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">69.5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">67.6</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">63.8</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</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; margin-left:3.00em; 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">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3.4</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3.5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3.7</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">11.9</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">12.1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">11.7</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">3.0</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2.9</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2.8</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">87.8</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">86.1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">82.0</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income from operations</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">12.2</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">13.9</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">18.0</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"><FONT STYLE="white-space:nowrap">Non-operating</FONT> expense, net</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2.1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2.0</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1.8</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income before income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10.1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">11.9</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">16.2</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">Income tax provision</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2.7</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2.6</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6.0</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">7.4</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">9.3</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10.2</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">57 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Year Ended December&nbsp;31, 2018 as Compared to Year Ended December&nbsp;31, 2017 </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our net revenue increased $188.8&nbsp;million, or 5.5%, to $3.65&nbsp;billion for the year ended December&nbsp;31, 2018, as compared to
$3.46&nbsp;billion for 2017. Of this increase, $102.1&nbsp;million, or 2.8%, was attributable to revenue generated from acquisitions completed after December&nbsp;31, 2016. Same-unit net revenue increased $86.7&nbsp;million, or 2.7%, for the year
ended December&nbsp;31, 2018. 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 $49.6&nbsp;million, or
1.5%, related to net reimbursement-related factors and an increase of $37.1&nbsp;million, or 1.2%, from patient service volumes. The net increase in revenue related to net reimbursement-related factors was primarily due to modest improvements in
managed care contracting, an increase in the administrative fees received from our hospital partners and the flow through of revenue from modest price increases, partially offset by a decrease in revenue caused by an increase in the percentage of
our patients enrolled in GHC Programs. The increase in revenue from patient service volumes was related to growth across almost all of our services. </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 $197.9&nbsp;million, or 8.5%, to $2.54&nbsp;billion for the year ended December&nbsp;31, 2018, as
compared to $2.34&nbsp;billion for 2017. This increase was primarily attributable to increased costs associated with physicians and other staff to support acquisition-related growth, organic growth initiatives and growth at our existing units, of
which $157.5&nbsp;million was related to salaries and $40.4&nbsp;million was related to benefits and incentive compensation. Included within practice salaries and benefits expense in 2018 is $18.1&nbsp;million for certain physicians who remained
employed through December&nbsp;31, 2018 despite the <FONT STYLE="white-space:nowrap">non-renewal</FONT> of an anesthesia services contract effective July&nbsp;1, 2018, under which they had previously provided services. 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. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Practice supplies and other operating expenses increased $1.5&nbsp;million, or 1.3%, to $122.0&nbsp;million for the year
ended December&nbsp;31, 2018, as compared to $120.5&nbsp;million for 2017. The increase was primarily attributable to practice supply, rent and other costs related to our acquisitions. </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 $15.3&nbsp;million, or 3.7%, to $432.4&nbsp;million for the year ended December&nbsp;31, 2018, as compared to $417.1&nbsp;million for
2017. The increase is attributable to the overall growth of the Company, including growth from acquisitions. Included within general and administrative expenses was an increase of $9.3&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. General and administrative expenses also includes a decrease of $25.0&nbsp;million resulting
from cost improvements as part of our shared services initiative. General and administrative expenses as a percentage of net revenue was 11.9% for the year ended December&nbsp;31, 2018, as compared to 12.1% 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 $8.4&nbsp;million, or 8.2%, to $111.3&nbsp;million for the year ended December&nbsp;31, 2018,
as compared to $102.9&nbsp;million for 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 decreased $34.3&nbsp;million, or 7.1%, to $445.8&nbsp;million for the year ended December&nbsp;31, 2018, as compared to
$480.1&nbsp;million for 2017. Our operating margin was 12.2% for the year ended December&nbsp;31, 2018, as compared to 13.9% for 2017. The decrease of 166 basis points was primarily due to the impact of the
<FONT STYLE="white-space:nowrap">non-renewal</FONT> of an anesthesia services contract effective July&nbsp;1, 2018, as well as higher operating expense growth as compared to revenue growth. </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">58 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Net <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses were $77.0&nbsp;million for
the year ended December&nbsp;31, 2018, as compared to $69.7&nbsp;million for 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 a higher effective
interest rate on borrowings outstanding 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 27.2% for the year ended
December&nbsp;31, 2018, as compared to 21.9% for 2017. Our effective income tax rate in 2017 was impacted by a $70.0&nbsp;million income tax benefit resulting from the reduction of our net deferred tax liability related to the reduction in the
corporate tax rate enacted under the Tax Cuts and Jobs Act of 2017 during the fourth quarter of 2017. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Net income was $268.6&nbsp;million
for the year ended December&nbsp;31, 2018, as compared to $320.4&nbsp;million for 2017. EBITDA was $568.9&nbsp;million for the year ended December&nbsp;31, 2018, as compared to $587.9&nbsp;million for 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 $2.93 on weighted average shares outstanding of 91.6&nbsp;million for the year
ended December&nbsp;31, 2018, as compared to $3.45 on weighted average shares outstanding of 93.0&nbsp;million for 2017. Adjusted EPS was $3.82 for the year ended December&nbsp;31, 2018, as compared to $3.34 for 2017. The decrease of
1.4&nbsp;million in our weighted average shares outstanding is primarily due to the impact of shares repurchased under our accelerated share repurchase program. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Year Ended December&nbsp;31, 2017 as Compared to Year Ended December&nbsp;31, 2016 </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our net revenue increased $275.2&nbsp;million, or 8.6%, to $3.46&nbsp;billion for the year ended December&nbsp;31, 2017, as compared to
$3.18&nbsp;billion for 2016. Of this $275.2&nbsp;million increase, $256.0&nbsp;million, or 7.9%, was attributable to revenue generated from acquisitions completed after December&nbsp;31, 2015. Same-unit net revenue increased $19.1&nbsp;million, or
0.7%, for the year ended December&nbsp;31, 2017. Same units are those units at which we provided services for the entire current period and the entire comparable period. The increase in same-unit net revenue was comprised of a net increase of
$11.7&nbsp;million, or 0.4%, related to net reimbursement-related factors and an increase in revenue of $7.4&nbsp;million, or 0.3%, from patient service volumes. The net increase in revenue of $11.7&nbsp;million related to net reimbursement-related
factors was primarily due to modest improvements in managed care contracting and an increase in the administrative fees received from our hospital partners, partially offset by a decrease in revenue caused by an increase in the percentage of our
patients enrolled in GHC Programs. The increase in revenue of $7.4&nbsp;million from patient service volumes was primarily related to growth across our anesthesiology, neonatology and maternal-fetal medicine services, partially offset by a decrease
in our other pediatric services, primarily hearing screen services. </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 $306.5&nbsp;million, or
15.1%, to $2.34&nbsp;billion for the year ended December&nbsp;31, 2017, as compared to $2.03&nbsp;billion for 2016. This $306.5&nbsp;million increase was primarily attributable to increased costs associated with new physicians and other staff to
support acquisition-related growth and growth at existing units, of which $230.6&nbsp;million was related to salaries and $75.9&nbsp;million was related to benefits and incentive compensation. Included within the increase in salaries expense at our
existing units were costs related to clinician compensation that increased at a faster rate than in previous periods. We anticipate that we will continue to experience a higher rate of growth in clinician compensation expense, which could adversely
affect our business, financial condition, results of operations, cash flows and the trading price of our securities. Included within the increase in benefits expense were increased costs related to malpractice expense driven by unfavorable claims
experience. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Practice supplies and other operating expenses increased $2.1&nbsp;million, or 1.8%, to $120.5&nbsp;million for the year
ended December&nbsp;31, 2017, as compared to $118.4&nbsp;million for 2016. The increase was attributable to practice supply, rent and other costs related to our acquisitions, partially offset by a decrease at our existing units. The decrease at our
existing units was primarily attributable to the reclassification of certain temporary staffing costs from practice operating expenses to practice salaries in 2017. </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">59 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; 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 $44.5&nbsp;million, or 12.0%, to $417.1&nbsp;million for the year ended December&nbsp;31, 2017, as compared
to $372.6&nbsp;million for 2016. The increase of $44.5&nbsp;million is attributable to the overall growth of the Company. General and administrative expenses as a percentage of net revenue was 12.1% for the year ended December&nbsp;31, 2017, as
compared to 11.7% for the same period in 2016. </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 $13.6&nbsp;million, or 15.3%, to
$102.9&nbsp;million for the year ended December&nbsp;31, 2017, as compared to $89.3&nbsp;million for 2016. The increase was primarily attributable to the amortization of intangible assets related to acquisitions. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Income from operations decreased $91.6&nbsp;million, or 16.0%, to $480.1&nbsp;million for the year ended December&nbsp;31, 2017, as compared
to $571.7&nbsp;million for 2016. Our operating margin was 13.9% for the year ended December&nbsp;31, 2017, as compared to 18.0% for 2016. The decrease of 408 basis points was primarily due to increases in operating expenses and lower same-unit
revenue. </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 $69.7&nbsp;million for the year ended December&nbsp;31,
2017, as compared to $57.9&nbsp;million for 2016. The net increase in <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses was primarily related to an increase in interest expense due to higher average borrowings outstanding under our
Credit Agreement. </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 21.9% for the year ended December&nbsp;31, 2017, as compared to 36.8% for 2016. After
excluding a $70.0&nbsp;million income tax benefit resulting from the reduction of our net deferred tax liability resulting from the reduction in the corporate tax rate enacted under the Tax Cuts and Jobs Act of 2017 during the fourth quarter of
2017, our effective income tax rate for the year ended December&nbsp;31, 2017 was 39.0%. After excluding a $10.6&nbsp;million income tax benefit resulting from the reversal of a liability for uncertain tax positions related to the favorable
settlement of a tax matter during the third quarter of 2016, our effective income tax rate for the year ended December&nbsp;31, 2016 was 38.9%. We believe that excluding the favorable impacts on our effective income tax rate related to these income
tax benefits provides a more comparable view of our effective income tax rate. After excluding these favorable impacts, our effective tax rate was relatively unchanged. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc. was $320.4&nbsp;million for the year ended December&nbsp;31, 2017, as compared to $324.9&nbsp;million
for 2016. EBITDA was $587.9&nbsp;million for the year ended December&nbsp;31, 2017, as compared to $666.5&nbsp;million for 2016. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Diluted
net income attributable to MEDNAX, Inc. per common and common equivalent share was $3.45 on weighted average shares outstanding of 93.0&nbsp;million for the year ended December&nbsp;31, 2017, as compared to $3.49 on weighted average shares
outstanding of 93.1&nbsp;million for 2016. Adjusted EPS was $3.34 for the year ended December&nbsp;31, 2017, as compared to $3.99 for 2016. </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 December&nbsp;31, 2018, we had $36.7&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 $157.2&nbsp;million at December&nbsp;31, 2018, an increase of $61.4&nbsp;million from our working capital of $95.8&nbsp;million at December&nbsp;31, 2017. This net
increase in working capital is primarily due to 2018 earnings, partially offset by the use of funds for repurchases of our common stock and acquisitions. </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">60 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Cash Flows </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; 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="84%" 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="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Operating activities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">289,925</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">511,378</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">443,778</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">(142,769</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(576,613</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(821,217</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">(170,611</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,737</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">381,565</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><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">We generated cash flow from operating activities of $289.9&nbsp;million, $511.4&nbsp;million and $443.8&nbsp;million for the years ended
December&nbsp;31, 2018, 2017 and 2016, respectively. The net decrease of $221.5&nbsp;million in cash flow provided from operating activities for the year ended December&nbsp;31, 2018, as compared to the year ended December&nbsp;31, 2017, was
primarily due to a decrease in cash flow from income taxes payable 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 as well
as a net decrease in cash flow related to accounts receivable, partially offset by an increase in cash flow related to changes in deferred taxes. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the year ended December&nbsp;31, 2018, cash flow from accounts receivable decreased by $44.4&nbsp;million, as compared to an increase
of $41.8&nbsp;million for 2017. The decrease in cash flow from accounts receivable was primarily due to an increase in DSO related to higher accounts receivable balances primarily at our existing units. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our cash flow from operating activities is significantly affected by the payment of physician incentive compensation. A large majority of our
affiliated physicians participate in our performance-based incentive compensation program and almost all of the payments due under the program are made annually in the first quarter. As a result, we typically experience negative cash flow from
operations in the first quarter of each year and fund our operations during this period with cash on hand or funds borrowed under our Credit Agreement. In addition, during the first quarter of each year, we use cash to make any discretionary
matching contributions for participants in our qualified contributory savings plans. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We generated cash flow from operating activities of
$511.4&nbsp;million and $443.8&nbsp;million for the years ended December&nbsp;31, 2017 and 2016, respectively. Cash flow for the year ended December&nbsp;31, 2017 was impacted by changes in the components of income taxes payable, accounts receivable
and professional liability reserves. Cash flow for the year ended December&nbsp;31, 2016 was impacted by an increase in the adjustment to net income for <FONT STYLE="white-space:nowrap">non-cash</FONT> depreciation and amortization expense, a net
increase in cash flow related to changes in the components of our accounts payable and accrued expenses and an increase in cash flow related to accounts receivable. </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
year ended December&nbsp;31, 2018, our net cash used in investing activities of $142.8&nbsp;million primarily included acquisition payments of $114.5&nbsp;million, capital expenditures of $48.9&nbsp;million and net purchases of $2.2&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
year ended December&nbsp;31, 2018, our net cash used in financing activities of $170.6&nbsp;million consisted primarily of net repayments on our Credit Agreement of $371.0&nbsp;million and the repurchase of $302.2&nbsp;million of our common stock,
partially offset by proceeds from our 2027 Notes of $500.0&nbsp;million. </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">61 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Liquidity </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. In November 2018, we amended and restated our Credit Agreement to make certain technical, conforming and other changes. The Credit Agreement matures on
October&nbsp;31, 2022 and is guaranteed by substantially all of our subsidiaries and affiliated professional associations and corporations. At our option, borrowings under the Credit Agreement will bear interest at (i)&nbsp;the alternate base rate
(defined as the higher of (a)&nbsp;the prime rate, (b)&nbsp;the Federal Funds Rate plus 1/2 of 1.00% and (c)&nbsp;LIBOR for an interest period of one month plus 1.00%) plus an applicable margin rate ranging from 0.125% to 0.750% based on our
consolidated leverage ratio or (ii)&nbsp;the LIBOR rate plus an applicable margin rate ranging from 1.125% to 1.750% based on our consolidated leverage ratio. The Credit Agreement also calls for other customary fees and charges, including an unused
commitment fee ranging from 0.150% to 0.300% of the unused lending commitments, based on our consolidated leverage ratio. The Credit Agreement contains customary covenants and restrictions, including covenants that require us to maintain a minimum
interest charge ratio, not to exceed a specified consolidated leverage ratio and to comply with laws, and restrictions on the ability to pay dividends and make certain other distributions, as specified therein. Failure to comply with these covenants
would constitute an event of default under the Credit Agreement, notwithstanding the ability of the company to meet its debt service obligations. The Credit Agreement also includes various customary remedies for the lenders following an event of
default, including the acceleration of repayment of outstanding amounts under the Credit Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">At December&nbsp;31, 2018, we had an
outstanding principal balance of $739.5&nbsp;million on our Credit Agreement. We also had outstanding letters of credit of $0.2&nbsp;million that reduced the amount available on our Credit Agreement to $1.3&nbsp;billion at December&nbsp;31, 2018.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In November 2018, we completed a private offering of $500.0&nbsp;million aggregate principal amount of 2027 Notes. At December&nbsp;31,
2018, we also had an outstanding principal balance of $750.0&nbsp;million on our 5.25% senior unsecured notes due 2023 (the &#147;2023 Notes&#148;). Our obligations under the 2023 Notes and the 2027 Notes are guaranteed on an unsecured senior basis
by the same subsidiaries and affiliated professional contractors that guarantee our Credit Agreement. Interest on the 2027 Notes accrues at the rate of 6.25% per annum, or $31.3&nbsp;million, and is payable semi-annually in arrears on
January&nbsp;15 and July&nbsp;15, beginning on January&nbsp;15, 2019. Interest on the 2023 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 Notes and the 2027 Notes are issued, among other things, limits our ability to (1)&nbsp;incur liens and
(2)&nbsp;enter into sale and lease-back transactions, and also limits our ability to merge or dispose of all or substantially all of our assets, in all cases, subject to a number of customary exceptions. Although we are not required to make
mandatory redemption or sinking fund payments with respect to the 2023 Notes and the 2027 Notes, upon the occurrence of a change in control of MEDNAX, we may be required to repurchase the 2023 Notes and the 2027 Notes at a purchase price equal to
101% of the aggregate principal amount of the 2023 Notes and the 2027 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
December&nbsp;31, 2018, we believe we were in compliance, in all material respects, with the financial covenants and other restrictions applicable to us under the Credit Agreement and the 2023 Notes and the 2027 Notes. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The exercise of employee stock options and the purchase of common stock by employees participating in our ESPP and SPP generated cash proceeds
of $16.3&nbsp;million, $23.3&nbsp;million, and $22.0&nbsp;million for the years ended December&nbsp;31, 2018, 2017 and 2016, respectively. Because stock option exercises and purchases under the ESPP and SPP are dependent on several factors,
including the market price of our common stock, we cannot predict the timing and amount of any future proceeds. </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 </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">62 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
under our professional liability insurance coverage through a wholly owned captive insurance subsidiary. We record liabilities for self-insured amounts and claims incurred but not reported based
on an actuarial valuation using historical loss information, claim emergence patterns and various actuarial assumptions. Our total liability related to professional liability risks at December&nbsp;31, 2018 was $244.0&nbsp;million, of which
$34.9&nbsp;million is classified as a current liability within accounts payable and accrued expenses in the Consolidated Balance Sheet. In addition, there is a corresponding insurance receivable of $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">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 expenses related to our
transformational and restructuring activities, fund our share repurchase programs and meet our contractual obligations as described below for at least the next 12 months from the date of issuance of this Form
<FONT STYLE="white-space:nowrap">10-K.</FONT> </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>CONTRACTUAL OBLIGATIONS </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">At December&nbsp;31, 2018, we had the following obligations and commitments (in thousands): </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="53%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="18" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Payments Due</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom" NOWRAP> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-bottom:1.00pt solid #000000; display:table-cell; font-size:8pt; font-family:Times New Roman; "><B>Obligation</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</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>2019</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>2020</B><br><B>and 2021</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>2022</B><br><B>and 2023</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>2024</B><br><B>and Later</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">Credit Agreement (1)</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 873,710</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 35,041</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 70,081</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 768,588</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></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">Senior Notes (1)</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,694,792</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70,625</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">141,250</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">887,969</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">594,948</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Capital leases</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">441</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">253</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">188</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></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 leases</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">103,478</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">30,824</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">39,984</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,148</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10,522</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>
<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">2,672,421</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">136,743</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">251,503</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,678,705</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">605,470</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>
<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 STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">(1)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Amounts include interest payments at the applicable rate as of December&nbsp;31, 2018 and assume the amount
outstanding under our Credit Agreement as of December&nbsp;31, 2018 will be paid on the maturity date and amounts outstanding under the 2023 Notes and the 2027 Notes will be paid on their maturity dates of December&nbsp;1, 2023 and January&nbsp;15,
2027, respectively. </P></TD></TR></TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Certain of our acquisition agreements contain contingent consideration provisions based on volume
and other performance measures over an up to five-year period. Potential payments under these provisions are not contingent upon the future employment of the sellers. As of December&nbsp;31, 2018, cash payments of up to $20.6&nbsp;million may be due
through 2020 under all contingent consideration provisions as follows (in thousands): </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="68%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">2019</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">17,900</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">2020</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,700</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">20,600</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:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">At December&nbsp;31, 2018, our total liability for uncertain tax positions was $12.3&nbsp;million, all of
which is included within other liabilities on our Consolidated Balance Sheets. The timing and amount of future cash flows for each year beyond 2018 cannot be reasonably estimated. See Note 11 to our Consolidated Financial Statements in this Form <FONT
STYLE="white-space:nowrap">10-K</FONT> for more information regarding our uncertain tax positions. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><FONT STYLE="white-space:nowrap">OFF-BALANCE</FONT>
SHEET ARRANGEMENTS </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">At December&nbsp;31, 2018, we leased, under operating lease agreements, space in hospitals and other facilities for
our business and medical offices, as well as certain equipment necessary for business operations, which are included in the table above. We did not have any other <FONT STYLE="white-space:nowrap">off-balance</FONT> sheet arrangements that have or
are reasonably likely to have a current or future effect on our financial condition, changes in financial condition, revenue or expenses, results of operations, liquidity, capital expenditures or capital resources. </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">63 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>RECENTLY ADOPTED ACCOUNTING PRONOUNCEMENTS </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; 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 us 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 guidance also 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. We had historically included the allowance for uncollectibles associated with patient responsibility amounts
with our 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 the increased
financial statement disclosures. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>NEW ACCOUNTING PRONOUNCEMENTS </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; 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 became effective for us on January&nbsp;1, 2019, with early adoption permitted. We expect
that the adoption of this guidance will have a material impact on our Consolidated Balance Sheets and related disclosures, resulting from the recognition of significant right of use assets and related liabilities primarily related to our operating
lease arrangements for space in hospitals and certain other facilities for its business and medical offices. We have completed the review of our existing lease portfolio and have accumulated all of the necessary information required to properly
account for leases under the new guidance. We have implemented a cloud-based software application, inclusive of a lease administration module and an accounting module. We are in the process of finalizing workflows, business processes and internal
controls surrounding the new lease accounting process in order to meet the reporting and disclosure requirements. </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">64 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_10"></A>ITEM&nbsp;7A.</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 December&nbsp;31, 2018, the outstanding principal balance on our Credit Agreement was $739.5&nbsp;million, and considering this outstanding balance, a 1% change in interest rates would result in an impact to income
before income taxes of $7.4&nbsp;million per 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">65 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_11"></A>ITEM&nbsp;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>FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA </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 Consolidated Financial Statements and Financial Statement Schedule of MEDNAX, Inc. and its subsidiaries are included in this Form
<FONT STYLE="white-space:nowrap">10-K</FONT> on the pages set forth below: </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>INDEX TO FINANCIAL STATEMENTS </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>AND FINANCIAL STATEMENT SCHEDULE </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B>Consolidated Financial Statements</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_21a">Report of Independent Registered Certified Public Accounting
Firm</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">67</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_22">Consolidated Balance Sheets at December&nbsp;31, 2018 and 2017</A></P></TD>

<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_23">Consolidated Statements of Income for the Years Ended December&nbsp;
31, 2018, 2017 and 2016</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_24">Consolidated Statements of Equity for the Years Ended December&nbsp;
31, 2018, 2017 and 2016</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">71</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_25">Consolidated Statements of Cash Flows for the Years Ended December&nbsp;
31, 2018, 2017 and 2016</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">72</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_26">Notes to Consolidated Financial Statements</A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">73</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><B>Financial Statement Schedule</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><A HREF="#tx671465_27">Schedule II&#151;Valuation and Qualifying Accounts for the Years Ended December&nbsp;31,
 2018, 2017 and 2016 </A></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">99</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">66 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx671465_21a"></A>Report of Independent Registered Public Accounting Firm </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">To the<B> </B>Board of Directors and shareholders of </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">MEDNAX,
Inc. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Opinions on the Financial Statements and Internal Control over Financial Reporting </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">We have audited the accompanying consolidated balance sheets of MEDNAX, Inc. and its subsidiaries<B> </B>(the &#147;Company&#148;) as of December&nbsp;31, 2018
and December&nbsp;31, 2017, and the related consolidated statements of income, equity, and cash flows for each of the three years in the period ended December&nbsp;31, 2018, including the related notes and financial statement schedule listed in the
accompanying index (collectively referred to as the &#147;consolidated financial statements&#148;). We also have audited the Company&#146;s internal control over financial reporting as of December&nbsp;31, 2018, based on criteria established in
<I>Internal Control&#151;Integrated Framework</I> (2013)&nbsp;issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">In
our opinion, the consolidated<B> </B>financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December&nbsp;31, 2018 and December&nbsp;31, 2017, and the results of<B> </B>their
operations and their cash flows for each of the three years in the period ended<B> </B>December&nbsp;31, 2018,<B> </B>in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company
maintained, in all material respects, effective internal control over financial reporting as of December&nbsp;31, 2018, based on criteria established in <I>Internal Control&#151;Integrated Framework</I> (2013)&nbsp;issued by the COSO. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Basis for Opinions </I></B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The Company&#146;s management
is responsible for these consolidated financial statements, for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness of internal control over financial reporting, included in Management&#146;s
Annual Report on Internal Control over Financial Reporting appearing under Item 9A. Our responsibility is to express opinions on the Company&#146;s consolidated financial statements and on the Company&#146;s internal control over financial reporting
based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities
laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">We conducted our audits in accordance with the
standards of the PCAOB. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the consolidated<B> </B>financial statements are free of material misstatement, whether due to error or fraud, and
whether effective internal control over financial reporting was maintained in all material respects. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Our audits of the consolidated financial statements
included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test
basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall
presentation of the consolidated financial statements. Our audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and
testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audits also included performing such other procedures as we considered necessary in the circumstances. We believe that our audits
provide a reasonable basis for our opinions. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Definition and Limitations of Internal Control over Financial Reporting </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">A company&#146;s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial
reporting and the preparation of financial statements for external purposes in </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">67 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
accordance with generally accepted accounting principles. A company&#146;s internal control over financial reporting includes those policies and procedures that (i)&nbsp;pertain to the
maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (ii)&nbsp;provide reasonable assurance that transactions are recorded as necessary to permit preparation
of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and
(iii)&nbsp;provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company&#146;s assets that could have a material effect on the financial statements. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of
effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">/s/ PricewaterhouseCoopers LLP </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Miami, Florida </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">February&nbsp;14, 2019 </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">We have served as the Company&#146;s
auditor since 1999.<SUP STYLE="font-size:85%; vertical-align:top"> </SUP> </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">68 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx671465_22"></A>CONSOLIDATED BALANCE SHEETS </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(in thousands) </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="78%"></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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" 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">$</TD>
<TD VALIGN="bottom" ALIGN="right">36,745</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</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">20,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&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">21,923</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">542,272</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">18,763</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">17,706</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">657,409</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="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Restricted cash</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom"><B>&nbsp;</B></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><B>&#151;&nbsp;&nbsp;</B></TD>
<TD NOWRAP VALIGN="bottom"><B>&nbsp;</B></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">69,699</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">133,037</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">4,382,995</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">588,312</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">103,459</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">$</TD>
<TD VALIGN="bottom" ALIGN="right">5,934,911</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</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&nbsp;&amp; SHAREHOLDERS&#146; EQUITY</B></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD>
<TD VALIGN="top"></TD></TR>
<TR STYLE="page-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">$</TD>
<TD VALIGN="bottom" ALIGN="right">469,342</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</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">253</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">30,598</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">500,193</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">739,500</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">1,234,780</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">209,060</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">131,240</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">32,254</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:5.00em; 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">2,847,027</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:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Preferred stock; $.01 par value; 1,000 shares authorized; none issued</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Common stock; $.01 par value; 200,000 shares authorized; 87,820 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">878</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:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Additional <FONT STYLE="white-space:nowrap">paid-in</FONT> capital</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">992,647</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:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Retained earnings</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,094,359</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:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total shareholders&#146; equity</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,087,884</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:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total liabilities and shareholders&#146; equity</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">5,934,911</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:40pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>The accompanying notes are an integral part of these Consolidated Financial Statements. </I></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">69 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx671465_23"></A>CONSOLIDATED STATEMENTS OF INCOME </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(in thousands, except for per share data) </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net revenue</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,647,123</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,458,312</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,183,159</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Operating expenses:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice salaries and benefits</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,535,588</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,337,734</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,031,220</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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">122,028</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">120,518</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">118,416</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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">432,378</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">417,105</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">372,572</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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">111,281</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">102,879</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,264</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,201,275</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,978,236</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,611,472</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income from operations</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">445,848</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">480,076</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">571,687</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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">4,935</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,953</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,019</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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">(88,769</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(74,559</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(63,092</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></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">6,825</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">952</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,185</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(77,009</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(69,654</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(57,888</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income before income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">368,839</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">410,422</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">513,799</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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">(100,210</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(90,050</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(189,203</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">268,629</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">324,596</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net loss attributable to noncontrolling interests</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">318</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">268,629</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">324,914</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Per common and common equivalent share data:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income attributable to MEDNAX, Inc.:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2.95</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.47</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.52</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2.93</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.45</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3.49</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Weighted average common shares:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">91,104</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,431</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,422</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">91,606</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,958</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,109</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="font-size:80pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P> <P STYLE="margin-top:80pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>The accompanying notes are an integral
part of these Consolidated Financial Statements. </I></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">70 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx671465_24"></A>CONSOLIDATED STATEMENTS OF EQUITY </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(in thousands) </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="45%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Common Stock</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD COLSPAN="2" VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD COLSPAN="2" VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD COLSPAN="2" VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD COLSPAN="2" VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Number&nbsp;of<BR>Shares</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Amount</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Additional</B><br><B><FONT STYLE="white-space:nowrap">Paid-in</FONT><BR>Capital</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Retained<BR>Earnings</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Noncontrolling<BR>Interests</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Total Equity</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at December&nbsp;31, 2015</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,739</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">937</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">926,235</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,510,356</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">318</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,437,846</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income (loss)</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">324,914</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(318</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">324,596</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Common stock issued under employee stock option, employee stock purchase plan and stock purchase
plan</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">473</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,017</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,022</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Issuance of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">505</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(5</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Stock-based compensation expense</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">34,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">34,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Forfeitures of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(53</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Repurchased common stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(946</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(9</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(12,075</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(49,744</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(61,828</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Excess tax benefit related to employee stock incentive plans</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,131</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,131</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at December&nbsp;31, 2016</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,718</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">937</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 974,304</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,785,526</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"> &#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,760,767</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Common stock issued under employee stock option, employee stock purchase plan and stock purchase
plan</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">528</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23,271</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23,276</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Issuance of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">536</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(5</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Issuance of restricted stock for</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">acquisition consideration</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,657</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,658</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Stock-based compensation expense</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29,573</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29,573</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Forfeitures of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(92</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Repurchased common stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,038</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(10</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(12,473</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(57,709</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(70,192</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at December&nbsp;31, 2017</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,721</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">937</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,017,328</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,048,189</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"> &#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,066,454</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">268,629</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">268,629</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Common stock issued under employee stock option, employee stock purchase plan and stock purchase
plan</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">495</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">18,914</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">18,919</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Issuance of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">770</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(8</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Stock-based compensation expense</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">38,703</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">38,703</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Stock swaps</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(56</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,660</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,661</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Forfeitures of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(69</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Repurchased common stock</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(7,041</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">(79,631</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(222,459</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(302,160</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at December&nbsp;31, 2018</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">87,820</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">878</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 992,647</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,094,359</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"> &#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,087,884</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:100pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>The accompanying notes are an integral part of these Consolidated Financial Statements. </I></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">71 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx671465_25"></A>CONSOLIDATED STATEMENTS OF CASH FLOWS </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(in thousands) </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:9pt" ALIGN="center">


<TR>
<TD WIDTH="67%"></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash flows from operating activities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 268,629</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 320,372</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 324,596</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Adjustments to reconcile net income to net cash provided from operating activities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Depreciation and amortization</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">111,281</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">102,879</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,264</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Amortization of premiums, discounts and issuance costs</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,572</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,514</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,816</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Stock-based compensation expense</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">38,703</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29,573</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">34,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Deferred income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(24,149</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(60,073</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">18,149</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Other</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(10,903</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,783</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">212</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Changes in assets and liabilities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Accounts receivable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(36,598</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">7,803</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(34,000</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Prepaid expenses and other current assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(5,472</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,792</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(783</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Other long-term assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(395</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,709</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10,035</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Accounts payable and accrued expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">15,390</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">24,551</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">11,617</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Income taxes payable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(61,256</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">73,050</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,234</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Payments of contingent consideration liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,093</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(750</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,037</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Long-term professional liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(4,490</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">18,478</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,452</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Other liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(4,294</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(735</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(7,405</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net cash provided from operating activities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">289,925</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">511,378</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">443,778</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash flows from investing activities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Acquisition payments, net of cash acquired</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(114,491</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(531,696</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(762,302</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Purchases of investments</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(15,884</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(27,723</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(60,976</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Proceeds from maturities of investments</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">13,710</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,410</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">41,325</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Purchases of property and equipment</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(48,868</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(49,309</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(39,264</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Proceeds from 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>
<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:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Other</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD 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">6,705</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net cash used in investing activities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(142,769</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(576,613</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(821,217</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash flows from financing activities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Borrowings on credit agreement</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,723,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,846,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,940,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Payments on credit agreement</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,094,500</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,699,000</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,510,000</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Proceeds from issuance of senior notes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">500,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Payments for financing costs</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(7,090</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,525</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Payments of contingent consideration liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(5,263</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(5,449</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(10,740</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Payments on capital lease obligations</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,356</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,267</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,130</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Excess tax benefit from exercises of stock options and vesting of restricted stock</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,241</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Proceeds from issuance of common stock</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">16,258</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23,276</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,022</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Contribution from noncontrolling interests</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD 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>
<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:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Repurchases of common stock</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(302,160</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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(61,828</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net cash (used in) provided from financing activities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(170,611</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,737</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">381,565</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Net (decrease) increase in cash and cash equivalents</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(23,455</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">24,502</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,126</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash, cash equivalents and restricted cash at beginning of year</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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">51,572</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash, cash equivalents and restricted cash at end of year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">56,745</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">80,200</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">55,698</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Supplemental disclosure of cash flow information:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Cash paid for:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:6.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Interest</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">82,540</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">73,837</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">60,453</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:6.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">185,416</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">75,427</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">175,962</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman"><FONT STYLE="white-space:nowrap">Non-cash</FONT> investing and financing activities:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:6.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Value of common stock issued for acquisitions</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,657</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:6.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Equipment financed through capital leases</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">684</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,619</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:9pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:6.00em; text-indent:-1.00em; font-size:9pt; font-family:Times New Roman">Property and equipment included in accounts payable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,927</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,700</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,673</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>The accompanying notes are an integral part of these Consolidated Financial Statements. </I></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">72 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx671465_26"></A>NOTES TO CONSOLIDATED FINANCIAL STATEMENTS </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>1.&nbsp;&nbsp;&nbsp;&nbsp;General: </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The
principal business activity of MEDNAX, Inc. (&#147;MEDNAX&#148; or the &#147;Company&#148;) and its subsidiaries is to provide neonatal, anesthesia, radiology and teleradiology, maternal-fetal and other pediatric subspecialty physician services. The
Company has contracts with affiliated business corporations or professional associations, limited liability companies and partnerships (&#147;affiliated professional contractors&#148;), which are separate legal entities that provide physician
services in certain states and Puerto Rico. The Company and its affiliated professional contractors also have contracts with hospitals and other healthcare facilities to provide physician services, which include <FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">(i)&nbsp;fee-for-service</FONT></FONT> contracts, whereby hospitals and other customers agree, in exchange for the Company&#146;s services, to authorize the Company and its healthcare professionals to bill and collect the
charges for medical services rendered by the Company&#146;s affiliated healthcare professionals, and (ii)&nbsp;administrative fee contracts, whereby the Company is assured a minimum revenue level. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition to its national physician network, the Company also provides services nationwide to healthcare providers, including its own,
through complementary businesses including a management services organization specializing in full-service revenue cycle management and a consulting services company. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><B>2.&nbsp;&nbsp;&nbsp;&nbsp;Summary</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>of Significant Accounting Policies: </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Principles of Presentation </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The
consolidated financial statements include all the accounts of the Company and its subsidiaries combined with the accounts of the affiliated professional contractors with which the Company currently has specific management arrangements. The
Company&#146;s agreements with affiliated professional contractors provide that the term of the arrangements are in most cases permanent, subject only to termination by the Company, except in the case of gross negligence, fraud or bankruptcy of the
Company. The Company has the right to receive income, both as ongoing fees and as proceeds from the sale of its interest in the Company&#146;s affiliated professional contractors, in an amount that fluctuates based on the performance of the
affiliated professional contractors and the change in the fair value of the Company&#146;s interest in the affiliated professional contractors. The Company has exclusive responsibility for the provision of all
<FONT STYLE="white-space:nowrap">non-medical</FONT> services required for the <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">day-to-day</FONT></FONT> operation and management of the Company&#146;s affiliated professional
contractors and establishes the guidelines for the employment and compensation of the physicians. In addition, the agreements provide that the Company has the right, but not the obligation, to purchase, or to designate a person(s) to purchase, the
stock of the Company&#146;s affiliated professional contractors for a nominal amount. Separately, in its sole discretion, the Company has the right to assign its interest in the agreements. Based upon the provisions of these agreements, the Company
has determined that the affiliated professional contractors are variable interest entities and that the Company is the primary beneficiary as defined in the accounting guidance for consolidation. All significant intercompany and interaffiliate
accounts and transactions have been eliminated. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company is a 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. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Recently Adopted Accounting Pronouncements </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; 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 </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">73 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
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 the Company&#146;s 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. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>New Accounting Pronouncements </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; 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 became 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 has accumulated all of the necessary information required to properly account for leases under the new guidance. The Company has implemented a cloud-based
software application, inclusive of a lease administration module and an accounting module. The Company is in the process of finalizing workflows, business processes and internal controls surrounding the new lease accounting process in order to meet
the reporting and disclosure requirements. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Accounting Estimates and Assumptions </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The preparation of financial statements in conformity with accounting principles generally accepted in the United States (&#147;GAAP&#148;)
requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and
expenses during the reporting periods. Significant estimates and assumptions are involved in the calculation of the Company&#146;s allowance for contractual adjustments and uncollectibles on accounts receivable, liabilities for self-insured amounts
and claims incurred but not reported related to the Company&#146;s professional liability risks and the fair value of goodwill. Actual results could differ from those estimates. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Segment Reporting </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The results of the
Company&#146;s operations are aggregated into a single reportable segment for purposes of presenting financial information in accordance with the accounting guidance for segment reporting. </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">74 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following table summarizes the Company&#146;s net revenue by service line (in percentages):
</P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Neonatology and other pediatric subspecialties</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">36</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">37</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">39</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">Anesthesiology</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">35</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">38</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">39</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">Radiology</P></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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Maternal-fetal medicine</P></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;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8</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</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</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">Pediatric cardiology</P></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>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&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:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Revenue Recognition </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; 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 GHC 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:12pt; margin-bottom:0pt; 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 GHC Programs and third-party insurance payors for such services. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; 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 GHC 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:12pt; margin-bottom:0pt; 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:12pt; margin-bottom:0pt; 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:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Accounts receivable are primarily amounts due under <FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">fee-for-service</FONT></FONT> contracts from third-party payors, such as insurance companies, self-insured employers and patients and GHC Programs geographically dispersed </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">75 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
throughout the United States and its territories. Concentration of credit risk relating to accounts receivable is limited by the number, diversity and geographic dispersion of the business units
managed by the Company, as well as by the large number of patients and payors, including the various governmental agencies in the states in which the Company provides services. Receivables from government agencies made up approximately 19% and 17%
of net accounts receivable at December&nbsp;31, 2018 and 2017, respectively. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Cash and Cash Equivalents </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Cash equivalents are defined as all highly liquid financial instruments with maturities of 90 days or less from the date of purchase. The
Company&#146;s cash equivalents typically consist of demand deposits, amounts on deposit in money market accounts, and funds invested in overnight repurchase agreements. Cash equivalent balances may, at certain times, exceed federally insured
limits. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Certain cash equivalents carried by the Company are subject to the fair value provisions of the accounting guidance for fair
value measurements. See &#147;Fair Value Measurements&#148; below. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Restricted Cash </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Restricted cash consists of funds in escrow related to a potential future payment for contingent consideration for an acquisition completed in
2017. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Investments </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; 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 five years. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; 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 securities. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Property and Equipment
</B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Property and equipment are recorded at original purchase cost. Depreciation of property and equipment is computed using the
straight-line method over the estimated useful lives of the underlying assets. Estimated useful lives are generally 30 years for buildings; three to seven years for medical equipment, computer equipment, software and furniture; and the lesser of the
useful life or the remaining lease term for leasehold improvements and capital leases. Upon sale or retirement of property and equipment, the related cost and accumulated depreciation are eliminated from the respective accounts and any resulting
gain or loss is included in earnings. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Business Acquisitions </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company accounts for all business acquisitions at fair value and expenses acquisition costs as they are incurred. Any identifiable assets
acquired and liabilities assumed are recognized and measured at their respective fair values on the acquisition date. If information about facts and circumstances existing as of the acquisition date is incomplete at the end of the reporting period
in which a business acquisition occurs, the Company will report provisional amounts for the items for which the accounting is incomplete. The measurement period ends once the Company receives sufficient information to finalize the fair values;
however, the period will not exceed one year from the acquisition date. Any adjustments to provisional amounts that are identified during the measurement period are recognized in the reporting period in which the adjustment amounts are determined.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In connection with certain acquisitions, the Company enters into agreements to pay additional amounts in cash or common stock based on
the achievement of certain performance measures for up to five years ending </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">76 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
after the acquisition dates. The Company measures this contingent consideration at fair value at the acquisition date and records such contingent consideration as a liability or equity on the
Company&#146;s Consolidated Balance Sheets on the acquisition date. The fair value of each contingent consideration liability is remeasured at each reporting period with any change in fair value recognized as income or expense within operations in
the Company&#146;s Consolidated Statements of Income. See Note 6 for more information on the Company&#146;s business acquisitions. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Goodwill and Other
Intangible Assets </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company records acquired assets and assumed liabilities at their respective fair values under the acquisition
method of accounting. Goodwill represents the excess of purchase price over the fair value of the net assets acquired. Intangible assets with finite lives, principally physician and hospital agreements, customer relationships, patented technology
and trade names, are recognized apart from goodwill at the time of acquisition based on the contractual-legal and separability criteria established in the accounting guidance. Intangible assets with finite lives are amortized on either an
accelerated basis based on the annual undiscounted economic cash flows associated with the particular intangible asset or on a straight-line basis over their estimated useful lives. Intangible assets with finite lives are amortized over periods of
one to 20 years. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Goodwill is tested for impairment at a reporting unit level on at least an annual basis in accordance with the
subsequent measurement provisions of the accounting guidance for goodwill. The Company defines a reporting unit based upon its management structure for services provided in specific regions of the United States. The Company early adopted new
accounting guidance in 2017 that requires only a single-step quantitative test with any goodwill impairment measured as the amount by which a reporting unit&#146;s carrying value exceeds its fair value. The Company uses income and market-based
valuation approaches to determine the fair value of its reporting units. These approaches focus on discounted cash flows and market multiples based on the Company&#146;s market capitalization to derive the fair value of a reporting unit. The Company
also considers the economic outlook for the healthcare services industry and various other factors during the testing process, including hospital and physician contract changes, local market developments, changes in third-party payor payments, and
other publicly available information. The Company completed annual impairment tests in the third quarter of each of 2018, 2017 and 2016 and determined that goodwill was not impaired in any of the three years. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Long-Lived Assets </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company is
required to evaluate long-lived assets, including intangible assets subject to amortization, whenever events or changes in circumstances indicate that the carrying value of the assets may not be fully recoverable. The recoverability of such assets
is measured by a comparison of the carrying value of the assets to the future undiscounted cash flows before interest charges to be generated by the assets. If long-lived assets are impaired, the impairment to be recognized is measured as the excess
of the carrying value over the fair value. Long-lived assets held for disposal are reported at the lower of the carrying value or fair value less disposal costs. The Company does not believe there are any indicators that would require an adjustment
to such assets or their estimated periods of recovery at December&nbsp;31, 2018 pursuant to current accounting standards. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Common Stock Repurchases
</B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company repurchases shares of its common stock as authorized from time to time by its Board of Directors. The Company treats
repurchased shares of its common stock as retired as any repurchased shares become authorized but unissued shares. The reacquisition cost of repurchased shares is recorded as a reduction in the respective components of shareholders&#146; equity.
</P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Professional Liability Coverage </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The
Company maintains professional liability insurance policies with third-party insurers generally on a claims-made basis, subject to deductibles or self-insured retention, exclusions and other restrictions. The
</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">77 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
Company&#146;s self-insured retention under its professional liability insurance program is maintained primarily through a wholly owned captive insurance subsidiary. The Company records an
estimate of liabilities for self-insured amounts and claims incurred but not reported based on an actuarial valuation using historical loss information, claim emergence patterns and various actuarial assumptions. Liabilities for claims incurred but
not reported are not discounted. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Income Taxes </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company records deferred income taxes using the liability method, whereby deferred tax assets and liabilities are determined based on the
difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. If it is more likely than not that all or a portion of deferred tax
assets will not be realized, a valuation allowance is provided against such deferred tax assets. In making such determination, the Company considers all available positive and negative evidence, including future reversals of existing taxable
temporary differences, projected future taxable income, <FONT STYLE="white-space:nowrap">tax-planning</FONT> strategies, and results of recent operations. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The accounting guidance for uncertain tax positions prescribes a recognition threshold and measurement attribute for financial statement
recognition and measurement of a tax position taken or expected to be taken in a tax return. The guidance also requires policy disclosures regarding penalties and interest and extensive disclosures regarding increases and decreases in uncertain tax
positions as a result of tax positions taken in a current or prior period, settlements with taxing authorities and any lapse of an applicable statute of limitations. Additional qualitative discussion is required for any tax position that may result
in a significant increase or decrease in uncertain tax positions within a <FONT STYLE="white-space:nowrap">12-month</FONT> period from the Company&#146;s reporting date. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Stock Incentive Plans </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company grants
stock-based awards consisting primarily of restricted stock to key employees under its Amended and Restated 2008 Incentive Compensation Plan, as amended. The Company measures the cost of employee services received in exchange for stock-based awards
based on grant-date fair value and allocates the resulting compensation expense over the corresponding requisite service period using the graded vesting attribution method. The Company also performs analyses to estimate forfeitures of stock-based
awards on an annual basis and adjusts the estimates as necessary based on the number of awards that ultimately vest. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Net Income Per Common Share
</B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; 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. On January&nbsp;1, 2017, the Company adopted new accounting guidance that no longer permits the Company to include the assumed excess tax benefits related to
the potential exercise or vesting of its stock-based awards in the treasury stock method computation. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Fair Value Measurements </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; 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 December&nbsp;31, 2018 and 2017, the Company&#146;s money market funds had a fair value of $0.5&nbsp;million and $9.2&nbsp;million, respectively. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; 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 </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">78 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
exchange-traded equity securities and mutual funds with quoted prices in active markets. In accordance with the three-tier fair value hierarchy, the Company determined the fair value using the
cash surrender value of the life insurance, a Level&nbsp;2 input as defined under the accounting guidance for fair value measurements. At December&nbsp;31, 2018 and 2017, the Company&#146;s cash surrender value of life insurance had a fair value of
$10.5&nbsp;million and $15.6&nbsp;million, respectively. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; 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 December&nbsp;31, 2018 and 2017, the Company&#146;s contingent consideration liabilities had a fair
value of $20.0&nbsp;million and $30.5&nbsp;million, respectively. See Note 6 for more information regarding the Company&#146;s contingent consideration liabilities. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; 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, variable rate long-term debt and capital lease obligations approximate fair value. If the Company&#146;s investments
were measured at fair value, they would be categorized as Level&nbsp;2 in the fair value hierarchy. If the Company&#146;s line of credit was measured at fair value, it would be categorized as Level&nbsp;2 in the fair value hierarchy. See Note 10 for
information regarding the fair value of the Company&#146;s 5.25% senior unsecured notes due 2023 (the &#147;2023 Notes&#148;) and 6.25% senior unsecured notes due 2027 (the &#147;2027 Notes&#148;). </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>3. &nbsp;&nbsp;&nbsp;&nbsp;Investments: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Investments held are summarized as follows (in thousands): </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="92%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="52%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31, 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">$</TD>
<TD VALIGN="bottom" ALIGN="right">18,473</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">30,841</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 VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">34,393</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">1,450</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,465</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">$</TD>
<TD VALIGN="bottom" ALIGN="right">21,923</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">69,699</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; text-indent:4%; font-size:10pt; font-family:Times New Roman">Contractual maturities of long-term investments are summarized as follows (in thousands): </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="74%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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">Due after one year through five years</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">69,699</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</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 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">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">$</TD>
<TD VALIGN="bottom" ALIGN="right">69,699</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</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="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>4. &nbsp;&nbsp;&nbsp;&nbsp;Accounts Receivable and Net Revenue: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Accounts receivable, net consists of the following (in thousands): </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="76%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="65%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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">Gross accounts receivable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,031,341</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</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">(1,489,069</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">$</TD>
<TD VALIGN="bottom" ALIGN="right">542,272</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</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: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">79 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Net revenue consists of the following (in thousands): </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="55%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net patient service revenue</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">3,067,784</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,915,648</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2,760,192</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: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">363,369</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">315,778</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">271,886</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">215,970</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">226,886</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">151,081</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">&nbsp;3,647,123</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">&nbsp;3,458,312</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">&nbsp;3,183,159</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following is a summary of our payor mix, expressed as a percentage of net revenue, exclusive of
administrative fees and revenue related to management services and other, for the periods indicated: </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Contracted managed care</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">70</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Government</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">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">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Other third-parties</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></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">2</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">100</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Accounts receivable of $542.3&nbsp;million and $504.0&nbsp;million at December&nbsp;31, 2018 and 2017,
respectively, consist primarily of amounts due from GHC Programs and third-party insurance payors for services provided by the Company&#146;s affiliated physicians. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Net revenue of $3.6&nbsp;billion, $3.5&nbsp;billion and $3.2&nbsp;billion for the years ended December&nbsp;31, 2018, 2017 and 2016,
respectively, consists primarily of gross billed charges for services provided by the Company&#146;s affiliated physicians less an estimated allowance for contractual adjustments and uncollectibles to properly account for the anticipated differences
between gross billed charge amounts and expected reimbursement amounts. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company&#146;s contractual adjustments and uncollectibles as
a percentage of gross patient service revenue vary slightly each year depending on several factors, including improved managed care contracting, changes in reimbursement from state Medicaid programs and other GHC Programs, shifts in the percentage
of patient services being reimbursed under GHC Programs and annual price increases. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company&#146;s annual price increases typically
increase contractual adjustments as a percentage of gross patient service revenue. This increase is primarily due to Medicaid, Medicare and other GHC Programs that generally provide for reimbursements on a
<FONT STYLE="white-space:nowrap">fee-schedule</FONT> basis rather than on a gross charge basis. When the Company bills these programs, like other payors, on a gross-charge basis, it also increases its provision for contractual adjustments and
uncollectibles by the amount of any price increase, resulting in a higher contractual adjustment percentage. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; 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:12pt; margin-bottom:0pt; 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 </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">80 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
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:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>5.&nbsp;&nbsp;&nbsp;&nbsp;Property and Equipment:
</B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Property and equipment 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="69%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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">Building</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">33,189</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">33,024</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">Land</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6,683</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6,683</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">Equipment and other</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">300,981</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">253,453</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">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">340,853</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">293,160</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">Accumulated depreciation</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(207,816</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(169,624</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">$</TD>
<TD VALIGN="bottom" ALIGN="right">133,037</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">123,536</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">At December&nbsp;31, 2018 and 2017, property and equipment includes medical and other equipment held under
capital leases of $4.8&nbsp;million and $6.1&nbsp;million, and related accumulated depreciation of $4.0&nbsp;million and $4.6&nbsp;million, respectively. The Company recorded depreciation expense of $38.5&nbsp;million, $33.9&nbsp;million and
$29.0&nbsp;million for the years ended December&nbsp;31, 2018, 2017 and 2016, respectively. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>6.&nbsp;&nbsp;&nbsp;&nbsp;Business Acquisitions: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the year ended December&nbsp;31, 2018, the Company completed nine physician group practice acquisitions, including five radiology
practices, two neonatology practices and two other pediatric subspecialty practices. The acquisition-date fair value of the total consideration for the nine acquisitions was $111.8&nbsp;million, net of cash acquired. In connection with these
acquisitions, the Company recorded goodwill of $95.0&nbsp;million, other intangible assets consisting primarily of physician and hospital agreements of $17.2&nbsp;million, current assets of $1.7&nbsp;million and other liabilities of
$2.1&nbsp;million. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">These acquisitions expanded the Company&#146;s national network of physician practices. The Company expects to improve
the results of physician practices through improved managed care contracting, improved collections and identification of growth initiatives, as well as operating and cost savings based on the significant infrastructure it has developed. With respect
to the Company&#146;s acquisition of radiology physician practices, the Company believes that it brings a unique value proposition to radiology physician groups, in that the Company can provide practice management support and a technology platform
enabling radiology to be practiced at a national level, as well as teleradiology capabilities that can enhance a physician group&#146;s efficiency, provide subspecialty access and help them to grow strategically and remain competitive while meeting
the demands of their hospital partners, third-party payors and regulatory bodies. In addition, the Company believes that radiology physician group practice physicians can complement the staffing needs for its teleradiology services business during
certain times, such as nights and weekends, when such physicians are not providing services at their practices. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the year ended
December&nbsp;31, 2018, in connection with certain prior-period acquisitions, the Company paid $6.4&nbsp;million for contingent consideration and $1.2&nbsp;million for purchase consideration that had been held back pending satisfaction of certain
conditions. Of these amounts, all except for the accretion recorded during 2018 were accrued as of December&nbsp;31, 2017. In addition, the Company recorded a decrease of $5.3&nbsp;million related to the change in the fair value of a contingent
consideration agreement for which the probability of the achievement of certain performance measures was updated. This change in fair value of contingent consideration was recorded within operating expenses. </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">81 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In connection with certain prior-period acquisitions, the Company also recorded a net increase in
goodwill of $4.0&nbsp;million composed of a decrease in current assets of $1.2&nbsp;million, a decrease in noncurrent assets of $1.5&nbsp;million and a decrease in liabilities of $0.2&nbsp;million for measurement-period adjustments resulting from
the finalization of acquisition accounting as well as additional cash consideration of $1.5&nbsp;million related to a working capital true up. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; 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:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">On November&nbsp;1, 2018, the Company announced the initiation
of a process to potentially divest the Company&#146;s management services service line to allow the Company to focus the organization on its core physician services business. There can be no assurance that this process will result in a transaction,
and the Company may decide to retain all or part of the management services service line. The Company had expected that the management services service line could be classified as assets and liabilities held for sale within the Company&#146;s
Consolidated Balance Sheets and that historical operating results of the service line could be reported as discontinued operations in the Company&#146;s Consolidated Statements of Income for the year ended December&nbsp;31, 2018; however, the
criteria for such classification was not met at December&nbsp;31, 2018. The management services service line continues to be classified as held and used as of December&nbsp;31, 2018. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the year ended December&nbsp;31, 2017, the Company completed 10 physician group practice acquisitions, including four radiology
practices, two maternal-fetal medicine practices, one neonatology practice, one pediatric multi-specialty practice and two other pediatric subspecialty practices. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">On March&nbsp;31, 2017, the Company sold its 75% economic interest in a joint venture that was previously consolidated. The deconsolidation
and removal of 100% of the carrying value of the joint venture&#146;s net assets resulted in a gain on sale that was not material. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>7.&nbsp;&nbsp;&nbsp;&nbsp;Goodwill and Intangible Assets: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Goodwill was $4.4&nbsp;billion and $4.3&nbsp;billion at December&nbsp;31, 2018 and 2017, respectively. The change in the carrying amount of
goodwill of $99.0&nbsp;million during the year ended December&nbsp;31, 2018 is primarily related to the Company&#146;s 2018 acquisitions. The Company expects that $63.0&nbsp;million of the goodwill recorded during the year ended December&nbsp;31,
2018 will be deductible for tax purposes. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; 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 December&nbsp;31, 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">82 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Intangible assets, net, 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="92%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="63%"></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31, 2018</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>Gross<BR>Carrying<BR>Value</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>Accumulated<BR>Amortization</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>Net<BR>Carrying<BR>Value</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">Physician and hospital agreements</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">&nbsp;376,871</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">&nbsp;(223,589)</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">&nbsp;153,282</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">Customer relationships</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">443,300</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(71,870</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">371,430</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">Trade names</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">43,156</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(4,630</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">38,526</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">Patented and other technology</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">47,561</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(22,487</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,074</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 910,888</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> (322,576)</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 588,312</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="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="63%"></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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>Gross<BR>Carrying<BR>Value</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>Accumulated<BR>Amortization</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>Net<BR>Carrying<BR>Value</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">Physician and hospital agreements</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">&nbsp;381,635</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">&nbsp;(203,915)</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">&nbsp;177,720</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">Customer relationships</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">443,300</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(48,837</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">394,463</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">Trade names</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">43,156</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,933</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">40,223</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">Patented and other technology</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">38,590</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(11,068</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">27,522</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 906,681</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> (266,753)</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 639,928</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the year ended December&nbsp;31, 2018, the Company recorded intangible assets related to acquisitions
totaling $17.2&nbsp;million, consisting primarily of physician and hospital agreements. The weighted-average amortization period for these physician and hospital agreements is approximately nine years. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Amortization expense for intangible assets was $72.8&nbsp;million, $68.9&nbsp;million and $60.3&nbsp;million for the years ended
December&nbsp;31, 2018, 2017 and 2016, respectively. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Amortization expense for existing intangible assets for the next five years is
expected to be as follows (in thousands): </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="68%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">2019</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">66,532</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">2020</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">59,969</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">2021</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">53,771</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">2022</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">46,249</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">2023</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">40,448</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>8.&nbsp;&nbsp;&nbsp;&nbsp;Accounts Payable and Accrued Expenses: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; 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="70%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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">Accounts payable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">31,059</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</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">249,834</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">80,369</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">34,931</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">18,760</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">9,477</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">44,912</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">$</TD>
<TD VALIGN="bottom" ALIGN="right">469,342</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</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: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">83 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>9.&nbsp;&nbsp;&nbsp;&nbsp;Accrued Professional Liabilities: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">At December&nbsp;31, 2018 and 2017, the Company&#146;s total accrued professional liabilities of $244.0&nbsp;million and $250.2&nbsp;million,
respectively, included incurred but not reported loss reserves of $139.1&nbsp;million and $138.5&nbsp;million, respectively, and loss reserves for reported claims of $104.9&nbsp;million and $111.7&nbsp;million, respectively. Of the total liability,
$34.9&nbsp;million is classified as a current liability within accounts payable and accrued expenses in the Consolidated Balance Sheet. In addition, there is a corresponding insurance receivable of $16.7&nbsp;million recorded as a component of other
assets for certain professional liability claims that are covered by third-party insurance policies. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The activity related to the
Company&#146;s total accrued professional liability for the years ended December&nbsp;31, 2018, 2017 and 2016 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="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="63%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at beginning of year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">250,187</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">202,052</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">202,527</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">Assumed liabilities through acquisition</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,276</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20,716</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:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Provision (adjustment) for losses related to:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Current year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">34,483</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">41,291</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">38,129</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Prior years</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10,299</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">9,983</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(25,428</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <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 provision for losses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">44,782</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">51,274</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">12,701</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">Claim payments related to:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Current year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(555</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(712</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(766</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">Prior years</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(51,699</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(23,143</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(12,410</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <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 payments</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(52,254</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(23,855</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(13,176</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at end of year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">243,991</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">250,187</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">202,052</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The net decrease in the Company&#146;s total accrued professional liability for the year ended
December&nbsp;31, 2018 was primarily related to an increase in claims payments made in the current year, partially offset by overall unfavorable trends in the Company&#146;s claims experience that impacted its provision for losses. The net increase
in the Company&#146;s total accrued professional liability for the year ended December&nbsp;31, 2017 was primarily related to overall unfavorable trends in the Company&#146;s claims experience that impacted its provision for losses and growth in the
program from acquisitions. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>10.&nbsp;&nbsp;&nbsp;&nbsp;Line of Credit, Long-Term Debt and Capital Lease Obligations: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company&#146;s 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. In November 2018, the Company amended and restated its Credit Agreement to make certain technical, conforming and other changes. The Credit Agreement matures on
October&nbsp;31, 2022 and is guaranteed by substantially all of the Company&#146;s subsidiaries and affiliated professional associations and corporations. At the Company&#146;s option, borrowings under the Credit Agreement will bear interest at
(i)&nbsp;the alternate base rate (defined as the higher of (a)&nbsp;the prime rate, (b)&nbsp;the Federal Funds Rate plus 1/2 of 1.00% and (c)&nbsp;LIBOR for an interest period of one month plus 1.00%) plus an applicable margin rate ranging from
0.125% to 0.750% based on the Company&#146;s consolidated leverage ratio or (ii)&nbsp;the LIBOR rate plus an applicable margin rate ranging from 1.125% to 1.750% based on the Company&#146;s consolidated leverage ratio. The Credit Agreement also
calls for other customary fees and charges, including an unused commitment fee ranging from 0.150% to 0.300% of the unused lending commitments, based on the Company&#146;s consolidated leverage ratio. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Agreement contains customary covenants and restrictions, including covenants that require the Company to maintain a minimum
interest charge ratio, not to exceed a specified consolidated leverage ratio and </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">84 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
to comply with laws, and restrictions on the ability of the Company to pay dividends and make certain other distributions, as specified therein. Failure to comply with these covenants would
constitute an event of default under the 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">In December 2015, the Company completed a
private offering of $750.0&nbsp;million aggregate principal amount of 2023 Notes. In November 2018, the Company completed a private offering of $500.0&nbsp;million aggregate principal amount of 2027 Notes. The Company&#146;s obligations under the
2023 Notes and the 2027 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 Notes accrues at the rate of 5.25% per annum and is
payable semi-annually in arrears on June&nbsp;1 and December 1. Interest on the 2027 Notes accrues at the rate of 6.25% per annum and is payable semi-annually in arrears on January&nbsp;15 and July&nbsp;15, with the initial interest payment due on
January&nbsp;15, 2019. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As of December&nbsp;31, 2018, the Company may redeem all or a portion of the 2023 Notes, at the redemption prices
of 102.625% in 2019, 101.313% in 2020 and 100% in 2021 and thereafter, plus accrued and unpaid interest to the redemption date. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">At any
time prior to January&nbsp;15, 2022, the Company may redeem all or a portion of the 2027 Notes at a redemption price equal to 100% of the principal amount of the notes being redeemed plus an applicable redemption premium and accrued and unpaid
interest to the redemption date. In addition, at any time prior to January&nbsp;15, 2022, the Company may redeem up to 35% of the aggregate principal amount of the 2027 Notes at a redemption price of 106.250% of the principal amount thereof, plus
accrued and unpaid interest, if any, to the redemption date, using proceeds from one or more equity offerings. On or after January&nbsp;15, 2022, the Company may redeem all or a portion of the 2027 Notes, at the redemption prices of 104.688% in
2022, 103.125% in 2023, 101.563% in 2024 and 100% in 2025 and thereafter, plus accrued and unpaid interest to the redemption date. </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 Notes and the 2027 Notes are issued, among other things, limits our ability to (1)&nbsp;incur liens and (2)&nbsp;enter into sale and lease-back transactions, and also limits our ability to merge or dispose of all or
substantially all of our assets, in all cases, subject to a number of customary exceptions. Although we are not required to make mandatory redemption or sinking fund payments with respect to the 2023 Notes or the 2027 Notes, upon the occurrence of a
change in control of MEDNAX, we may be required to repurchase the 2023 Notes or the 2027 Notes at a purchase price equal to 101% of the aggregate principal amount of the 2023 Notes and the 2027 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">The carrying value of the Company&#146;s long-term debt was $2.0&nbsp;billion and $1.8&nbsp;billion at December&nbsp;31, 2018 and 2017,
respectively, and consisted of the following (in thousands): </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="56%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31, 2018</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>Principal</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>Unamortized<BR>Debt<BR>Issuance<BR>Costs</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</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">Senior Notes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,250,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">(15,408</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,234,592</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">Revolving line of credit</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">739,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(4,274</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">735,226</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,989,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">(19,682</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,969,818</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">85 </P>


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


<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="56%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31, 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>Principal</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>Unamortized<BR>Debt<BR>Issuance<BR>Costs</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</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">Senior Notes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">750,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">(9,503</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">740,497</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">Revolving line of credit</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,110,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(4,864</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,105,636</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,860,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">(14,367</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,846,133</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company presents issuance costs related to long-term debt liabilities, other than revolving credit
arrangements, as a direct deduction from the carrying value of that long-term debt. The Company has outstanding letters of credit which reduced the amount available under the Credit Agreement by $0.2&nbsp;million at December&nbsp;31, 2018. At
December&nbsp;31, 2018, the Company had an available balance on its Credit Agreement of $1.3&nbsp;billion. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The carrying values of the
Company&#146;s variable rate revolving line of credit approximates fair value due to the short-term nature of the interest rates. The estimated fair value of the Company&#146;s 2023 Notes and 2027 Notes were estimated using trading prices as of
December&nbsp;31, 2018 and 2017, respectively, as Level&nbsp;2 inputs to estimate fair value and 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:8pt" ALIGN="center">


<TR>
<TD WIDTH="70%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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">2023 Notes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">736,725</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">763,125</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">2027 Notes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">482,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom"><B>&nbsp;</B></TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right"><B>&#151;&nbsp;&nbsp;</B></TD>
<TD NOWRAP VALIGN="bottom"><B>&nbsp;</B></TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company&#146;s capital lease obligations 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="76%"></TD>
<TD VALIGN="bottom" WIDTH="8%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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">Capital lease obligations</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">441</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,826</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">Less: Current portion</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(253</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 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">Long-term portion</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">188</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">425</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The amounts due under the terms of the Company&#146;s capital lease obligations at December&nbsp;31, 2018 are
as follows: </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="68%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="89%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">2019</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">253</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">2020</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">114</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">2021</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">74</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">86 </P>


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

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


<TR>
<TD WIDTH="63%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Federal:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Current</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">97,754</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">130,053</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">166,758</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Deferred</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(20,176</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(63,038</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">15,596</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">77,578</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">67,015</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">182,354</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">State:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Current</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">26,605</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20,070</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,296</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Deferred</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,973</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,965</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,553</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,632</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23,035</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6,849</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">100,210</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">90,050</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">189,203</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company files its tax return on a consolidated basis with its subsidiaries, and its affiliated
professional contractors file tax returns on an individual basis. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Beginning on January&nbsp;1, 2018, the Company&#146;s statutory tax
rate was reduced from 35.0% to 21.0% as a result of legislation enacted under the Tax Cuts and Jobs Act of 2017 (&#147;TCJA&#148;). The effective tax rate was 27.2%, 21.9% and 36.8% for the years ended December&nbsp;31, 2018, 2017 and 2016,
respectively. During the three months ended December&nbsp;31, 2017, the Company recorded a $70.0&nbsp;million income tax benefit related to the reduction of its net deferred tax liability resulting from the reduction in the corporate tax rate under
the TCJA. During the three months ended September&nbsp;30, 2016, the Company settled a certain tax matter with a taxing authority. In connection with this settlement, the Company&#146;s effective income tax rate was favorably impacted by
$10.6&nbsp;million. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The differences between the effective rate and the United States federal income tax statutory rate are as follows:
</P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Tax at statutory rate</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">21.00</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">35.00</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">35.00</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">State income tax, net of federal benefit</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4.80</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3.33</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2.94</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><FONT STYLE="white-space:nowrap">Non-deductible</FONT> expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.44</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.49</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.43</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Change in accrual estimates relating to uncertain tax positions</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.05</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.02</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2.11</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Change in valuation allowance</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.48</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Other, net</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1.20</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.16</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.06</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Change in tax law</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(0.32</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(17.06</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income tax provision</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">27.17</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">21.94</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">36.80</TD>
<TD NOWRAP VALIGN="bottom">%&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">87 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">All of the Company&#146;s deferred tax assets and liabilities are classified as long-term. The
significant components of deferred income tax assets and liabilities are as follows (in thousands): </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="69%"></TD>
<TD VALIGN="bottom" WIDTH="6%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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">Allowance for uncollectible accounts</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">194,876</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">80,056</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">Reserves and accruals</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">59,270</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">45,454</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Stock-based compensation</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">9,201</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">7,975</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net operating loss carryforward</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,226</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">28,569</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Property and equipment</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">26</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">685</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Other</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,197</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">970</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Deferred tax assets before valuation allowance</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">289,796</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">163,709</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">Less: Valuation allowance</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,628</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,615</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Deferred tax assets, net of valuation allowance</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">287,168</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">161,094</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Gross deferred tax 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">Amortization</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(286,552</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(258,618</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"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Accounting method changes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(109,418</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(4,150</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">Accrual to cash adjustment</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(39</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(31,290</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</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(489</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="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 deferred tax liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(396,498</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(294,058</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">Net deferred tax liability</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">(109,330</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">(132,964</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company&#146;s net deferred tax liability decreased by $23.6&nbsp;million during 2018. During 2018,
certain of the Company&#146;s affiliated professional contractors elected to change their method of accounting from cash basis to accrual basis for income tax purposes. During the year ended December&nbsp;31, 2018, the increases in allowance for
uncollectible accounts of $114.8&nbsp;million and accounting method changes of $105.3&nbsp;million as well as the decrease in accrual to cash adjustment of $31.3&nbsp;million primarily relate to these accounting method changes. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Beginning January&nbsp;1, 2017, excess tax benefits or deficiencies associated with the exercise of stock options, the vesting of restricted
and deferred stock and the purchase of shares under the Company&#146;s <FONT STYLE="white-space:nowrap">non-qualified</FONT> employee stock purchase plan are recognized as income tax benefits or expenses in the income statement in the reporting
period in which they occur instead of an increase or decrease to additional <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">paid-in-capital.</FONT></FONT> For the years ended December&nbsp;31, 2018 and 2017, income tax expense of
$1.4&nbsp;million and $0.2&nbsp;million, respectively, was recognized for excess tax deficiencies. For the year ended December&nbsp;31, 2016, additional <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">paid-in-capital</FONT></FONT>
was increased by $4.2&nbsp;million for excess tax benefits. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company has net operating loss carryforwards for federal and state tax
purposes totaling $101.9&nbsp;million, $116.0&nbsp;million and $130.0&nbsp;million at December&nbsp;31, 2018, 2017 and 2016, respectively. With respect to the December&nbsp;31, 2018 balance, approximately $74.3&nbsp;million expires at various times
from 2019 through 2038, and $27.6&nbsp;million does not expire. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As of December&nbsp;31, 2018, 2017 and 2016, the Company&#146;s liability
for uncertain tax positions, excluding accrued interest and penalties, was $11.2&nbsp;million, $11.0&nbsp;million and $9.5&nbsp;million, respectively. As of December&nbsp;31, 2018, the Company had $10.9&nbsp;million of uncertain tax positions that,
if recognized, would favorably impact its effective tax rate. </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">88 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following table summarizes the activity related to the Company&#146;s liability for uncertain
tax positions for the years ended December&nbsp;31, 2018, 2017 and 2016 (in thousands): </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="66%"></TD>
<TD VALIGN="bottom" WIDTH="5%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="4%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at beginning of year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">10,972</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 9,469</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">18,447</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">Increases related to prior year tax positions</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">385</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,284</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">301</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">Decreases related to prior year tax positions</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">(143</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,927</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">Increases related to current year tax positions</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,900</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,430</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,258</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">Settlements</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 VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(5,644</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">Decreases related to lapse of statutes of limitation</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,072</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,068</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,966</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at end of year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">11,185</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">10,972</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">9,469</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the years ended December&nbsp;31, 2018 and 2017, the Company increased its liability for uncertain tax
positions by a total of $0.2&nbsp;million and $1.5&nbsp;million, respectively, primarily related to additional taxes on current and prior year positions, partially offset by the expiration of statutes of limitation. In addition, the Company
anticipates that its liability for uncertain tax positions will increase by $0.2&nbsp;million over the next 12 months. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company
includes interest and penalties related to income tax liabilities in income tax expense. The income tax benefit recognized by the Company for interest and penalties during the year ended December&nbsp;31, 2018 was nominal. The Company recognized
income tax benefits of $0.2&nbsp;million and $7.9&nbsp;million related to interest and penalties during the years ended December&nbsp;31, 2017 and 2016, respectively. At December&nbsp;31, 2018 and 2017, the Company&#146;s accrued liability for
interest and penalties related to income tax liabilities totaled $1.1&nbsp;million and $1.2&nbsp;million, respectively. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company is
currently subject to U.S. Federal and various state income tax examinations for the tax years 2014 through 2017. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>12. &nbsp;&nbsp;&nbsp;&nbsp;Common
and Common Equivalent Shares: </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The calculation of shares used in the basic and diluted net income per share calculation for the years
ended December&nbsp;31, 2018, 2017 and 2016 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="73%"></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="10" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Years Ended December&nbsp;31,</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>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>2016</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">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">91,104</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,431</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,422</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">502</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">527</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">687</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">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">91,606</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,958</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,109</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<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">214</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">107</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>13. &nbsp;&nbsp;&nbsp;&nbsp;Stock Incentive Plans and Stock Purchase Plans: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; 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:12pt; margin-bottom:0pt; 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 </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">89 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
exercised within 10 years from the date of grant and generally become exercisable on a pro rata basis over a three-year period from the date of grant. The Company issues new shares of its common
stock upon exercise of its stock options. Restricted stock awards generally vest over periods of three years upon the fulfillment of specified service-based conditions and in certain instances performance-based conditions. Deferred stock awards
generally vest upon the satisfaction of specified performance-based conditions or service-based conditions. The Company recognizes compensation expense related to its restricted stock and deferred stock awards ratably over the corresponding vesting
periods. At December&nbsp;31, 2018, the Company had 2.0&nbsp;million shares available for future grants and awards under its Amended and Restated 2008 Incentive Plan. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; 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:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of the ESPP and the SPP provide for the issuance
of an of aggregate 2.6&nbsp;million shares of the Company&#146;s common stock less the number of shares of common stock purchased under the other plan. The Company recognizes stock-based compensation expense for the discount received by
participating employees and <FONT STYLE="white-space:nowrap">non-employee</FONT> service providers. During the year ended December&nbsp;31, 2018, 0.4&nbsp;million shares were issued under the ESPP and SPP. At December&nbsp;31, 2018, the Company had
1.6&nbsp;million shares in aggregate reserved for issuance under the ESPP and SPP. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company recognized $38.7&nbsp;million,
$29.6&nbsp;million and $34.0&nbsp;million of stock-based compensation expense related to its stock incentive plans, the ESPP and the SPP during the years ended December&nbsp;31, 2018, 2017 and 2016, respectively. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The activity related to the Company&#146;s restricted stock and deferred stock awards and the corresponding weighted average grant-date fair
values for the year ended December&nbsp;31, 2018 are as follows: </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="8%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; 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>Number of</B><br><B>Shares</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>Weighted<BR>Average&nbsp;Fair<BR>Value</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"><FONT STYLE="white-space:nowrap">Non-vested</FONT> shares at January&nbsp;1, 2018</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,041,034</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">60.21</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Awarded</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">770,480</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">51.99</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">Forfeited</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(69,293</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">56.65</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Vested</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(431,368</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">63.57</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"></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"><FONT STYLE="white-space:nowrap">Non-vested</FONT> shares at December&nbsp;31, 2018</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,310,853</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">54.46</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The aggregate fair value of the restricted and deferred stock that vested during the years ended
December&nbsp;31, 2018, 2017 and 2016 was $27.4&nbsp;million, $29.3&nbsp;million and $29.8&nbsp;million, respectively. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The weighted
average grant-date fair value of restricted and deferred stock awards that were granted during the years ended December&nbsp;31, 2018, 2017 and 2016 was $51.99, $54.22 and $67.90, respectively. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">At December&nbsp;31, 2018, the total stock-based compensation cost related to <FONT STYLE="white-space:nowrap">non-vested</FONT> restricted
and deferred stock remaining to be recognized as compensation expense over a weighted-average period of 1.4 years was $30.8&nbsp;million. </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">90 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company did not grant any stock options in 2018, 2017, or 2016, and all stock-based
compensation cost related to stock options has been recognized. The activity and certain other information related to the Company&#146;s outstanding stock option awards for the year ended December&nbsp;31, 2018 are 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="51%"></TD>
<TD VALIGN="bottom" WIDTH="8%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="8%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="8%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; 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>Number&nbsp;of</B><br><B>Stock&nbsp;Options</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>Weighted</B><br><B>Average</B><br><B>Exercise</B><br><B>Price</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>Weighted<BR>Average<BR>Remaining<BR>Contractual<BR>Term</B><br><B>(in years)</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>Aggregate<BR>Intrinsic</B><br><B>Value</B><br><B>(in<BR>millions)</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">Outstanding at January&nbsp;1, 2018</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">246,342</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">27.51</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Exercised</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(133,366</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">27.38</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">2.8</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Outstanding and exercisable at December&nbsp;31, 2018</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">112,976</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">27.65</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1.3</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.7</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"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The aggregate intrinsic value of stock options exercised during the years ended December&nbsp;31, 2018, 2017
and 2016 was $2.8&nbsp;million, $5.5&nbsp;million and $6.8&nbsp;million, respectively. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">There were no excess tax benefits recognized in
additional <FONT STYLE="white-space:nowrap">paid-in</FONT> capital in 2018 or 2017 due to the adoption of new accounting guidance on January&nbsp;1, 2017 that requires excess tax benefits to be recognized in the income statement. The net excess tax
benefit recognized in additional <FONT STYLE="white-space:nowrap">paid-in</FONT> capital related primarily to stock options, restricted stock and deferred stock for the year ended December&nbsp;31, 2016 was $4.1&nbsp;million. The cash proceeds
received from the exercise of stock options for the years ended December&nbsp;31, 2018, 2017 and 2016 were $3.7&nbsp;million, $4.8&nbsp;million and $4.7&nbsp;million, respectively. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>14. &nbsp;&nbsp;&nbsp;&nbsp;Common Stock Repurchase Programs: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; 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. 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. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In August 2018, the Company announced that its Board of Directors had
authorized the repurchase of up to $500.0&nbsp;million of the Company&#146;s common stock in addition to its existing share repurchase program. As part of this repurchase program, on August&nbsp;31, 2018, the Company entered into an uncollared
accelerated share repurchase (&#147;ASR&#148;) agreement with an investment bank. Under the ASR agreement, the Company agreed to purchase $250.0&nbsp;million of its common stock in total. On September&nbsp;4, 2018, the Company paid a total of
$250.0&nbsp;million to the investment bank, which in turn delivered to the Company approximately 4.2&nbsp;million shares of the Company&#146;s common stock in total based on the market price of a share of Company common stock on August&nbsp;31,
2018. The payment was recorded as a reduction to the respective components of shareholders&#146; equity. The ASR agreement was funded by borrowings under the Company&#146;s Credit Agreement discussed in Note 10. Final settlement of the ASR occurred
in December 2018 with the delivery to the Company of approximately 1.7&nbsp;million additional shares of common stock. The final number of shares of common stock that the Company received was based upon the average daily volume weighted-average
price of the Company&#146;s common stock during the term of the ASR agreement, less a negotiated discount. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Under the share repurchase
programs described above, the Company repurchased approximately 7.0&nbsp;million shares of its common stock for approximately $302.2&nbsp;million during the year ended December&nbsp;31, 2018, 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 second 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">91 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the year ended December&nbsp;31, 2017, the Company repurchased 1.0&nbsp;million shares of
its common stock for $70.2&nbsp;million, inclusive of 38,257 shares withheld to satisfy minimum statutory withholding obligations of $2.1&nbsp;million in connection with the vesting of restricted stock. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>15. &nbsp;&nbsp;&nbsp;&nbsp;Retirement Plans: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company maintains six qualified contributory savings plans as allowed under Section&nbsp;401(k) of the Internal Revenue Code and
Section&nbsp;1165(e) of the Puerto Rico Income Tax Act of 1954 (the &#147;401(k) Plans&#148;). The 401(k) Plans permit participant contributions and allow elective and, in certain situations, <FONT STYLE="white-space:nowrap">non-elective</FONT>
Company contributions based on each participant&#146;s contribution or a specified percentage of eligible wages. Participants may defer a percentage of their annual compensation subject to the limits defined in the 401(k) Plans. The Company recorded
expense of $55.8&nbsp;million, $50.7&nbsp;million and $45.2&nbsp;million for the years ended December&nbsp;31, 2018, 2017 and 2016, respectively, primarily related to the 401(k) Plans. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>16. &nbsp;&nbsp;&nbsp;&nbsp;Commitments and Contingencies: </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; 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 December&nbsp;31, 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:12pt; margin-bottom:0pt; 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:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Although the Company currently maintains liability insurance coverage intended to cover professional
liability and certain other claims, the Company cannot assure that its insurance coverage will be adequate to cover liabilities arising out of claims asserted against it in the future where the outcomes of such claims are unfavorable. With respect
to professional liability risk, the Company generally self-insures a portion of this risk through its wholly owned captive insurance subsidiary. Liabilities in excess of the Company&#146;s insurance coverage, including coverage for professional
liability and certain other claims, could have a material adverse effect on the Company&#146;s business, financial condition, results of operations, cash flows and the trading price of its securities. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company leases space for its regional, medical and business offices, storage space and temporary housing of medical staff. The Company
also leases an aircraft. Rent expense for the years ended December&nbsp;31, 2018, 2017 and 2016 was $42.9&nbsp;million, $42.6&nbsp;million and $38.0&nbsp;million, respectively. </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">92 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Future minimum lease payments under <FONT STYLE="white-space:nowrap">non-cancelable</FONT>
operating leases as of December&nbsp;31, 2018 are as follows (in thousands):<B></B><B>&nbsp;</B> </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="68%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">2019</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 30,824</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">2020</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,038</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">2021</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">17,946</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">2022</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">12,708</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">2023</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">9,440</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Thereafter</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10,522</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">103,478</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>17.&nbsp;&nbsp;&nbsp;&nbsp;Selected Quarterly Financial Information (Unaudited): </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following tables set forth a summary of the Company&#146;s selected quarterly financial information for each of the four quarters ended
December&nbsp;31, 2018 and 2017 (in thousands, except for per share data): </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="64%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="14" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2018 Quarters</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>First</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Second</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Third</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Fourth</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net revenue</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">901,857</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">915,918</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">896,652</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">932,696</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Operating expenses:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice salaries and benefits</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">631,830</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">625,717</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">657,061</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice supplies and other operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">30,655</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">30,159</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29,381</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">General and administrative expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">108,776</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">102,905</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">112,789</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Depreciation and amortization</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">26,163</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">28,709</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29,891</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">797,424</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">787,490</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">829,122</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">104,433</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">109,162</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">103,574</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">1,464</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">1,302</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">967</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">(19,935</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&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">(21,782</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(25,448</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">1,525</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">1,766</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,277</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(16,946</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&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">(18,714</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(22,204</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income before income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">87,487</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">90,448</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">81,370</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">(24,059</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&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">(24,873</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(21,156</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 63,428</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">79,412</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">65,575</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">60,214</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Per common and common equivalent share data (1):</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.68</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.85</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.72</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.68</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.85</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.72</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.68</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Weighted average common shares:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,859</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">90,984</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">87,810</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">93,505</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">91,359</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">88,258</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">(1)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Basic and diluted per share amounts are computed for each of the periods presented. Accordingly, the sum of the
quarterly per share amounts may not agree with the full year amount. </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">93 </P>


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


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


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net revenue</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">835,597</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">842,944</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">868,951</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">910,820</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Operating expenses:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice salaries and benefits</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">572,385</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">561,418</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">586,476</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">617,455</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Practice supplies and other operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">27,796</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">30,872</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29,497</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">32,353</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">General and administrative expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">103,765</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">103,015</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">101,430</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">108,895</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:5.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Depreciation and amortization</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,614</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,735</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,116</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">26,414</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total operating expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">729,560</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">721,040</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">742,519</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">785,117</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income from operations</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">106,037</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">121,904</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">126,432</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">125,703</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Investment and other income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">576</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">365</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">235</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,777</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Interest expense</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(17,752</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(18,535</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(18,428</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(19,844</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Equity (loss) in earnings of unconsolidated affiliate</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">797</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">689</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(240</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(294</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(16,379</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(17,481</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(18,433</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(17,361</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income before income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">89,658</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">104,423</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">107,999</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">108,342</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Income tax (provision) benefit</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(34,967</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(40,725</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(42,119</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">27,761</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right"> 54,691</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">63,698</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">65,880</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">136,103</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Per common and common equivalent share data (2):</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net income:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.59</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.71</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.47</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.59</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.71</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.46</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Weighted average common shares:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Basic</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,360</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,181</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,589</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,756</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:7.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Diluted</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,143</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,812</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,881</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,159</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">(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">Basic and diluted per share amounts are computed for each of the periods presented. Accordingly, the sum of the
quarterly per share amounts may not agree with the full year amount. </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">94 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="9%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_12"></A>ITEM&nbsp;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>CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE
</B></P></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">None. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_13"></A>ITEM&nbsp;9A.</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">We carried out an evaluation, under the supervision and with the participation of our management, including our Chief Executive Officer and
Chief Financial Officer, of the effectiveness of our disclosure controls and procedures (as defined in Rules <FONT STYLE="white-space:nowrap">13a-15(e)</FONT> and <FONT STYLE="white-space:nowrap">15d-15(e)</FONT> under the Securities Exchange Act of
1934, as amended). Based upon that evaluation, the Chief Executive Officer and Chief Financial Officer have concluded that our disclosure controls and procedures were effective as of the end of the period covered by this report. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Management&#146;s Annual Report on Internal Control Over Financial Reporting </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Management of the Company is responsible for establishing and maintaining adequate internal control over financial reporting as defined in Rule
<FONT STYLE="white-space:nowrap">13a-15(f)</FONT> or <FONT STYLE="white-space:nowrap">15d-15(f)</FONT> promulgated under the Securities Exchange Act of 1934, as amended. The Company&#146;s internal control over financial reporting includes those
policies and procedures that (i)&nbsp;pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the Company; (ii)&nbsp;provide reasonable assurance that
transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the Company are being made only in accordance with authorizations
of management and directors of the Company; and (iii)&nbsp;provide reasonable assurance regarding the prevention or timely detection of unauthorized acquisition, use, or disposition of the Company&#146;s assets that could have a material effect on
the Company&#146;s financial statements. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Internal control over financial reporting is designed to provide reasonable assurance regarding
the reliability of financial reporting and the preparation of financial statements prepared for external purposes in accordance with generally accepted accounting principles. Because of its inherent limitations, internal control over financial
reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance
with the policies or procedures may deteriorate. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Management assessed the effectiveness of the Company&#146;s internal control over
financial reporting as of the end of the period covered by this report. In making this assessment, management used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission (&#147;COSO&#148;) in &#147;Internal
Control&#151;Integrated Framework (2013).&#148; Based on our assessment we concluded that, as of the end of the period covered by this report, the Company&#146;s internal control over financial reporting was effective based on those criteria. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company&#146;s independent registered certified public accounting firm, PricewaterhouseCoopers LLP, has audited our internal control over
financial reporting as of December&nbsp;31, 2018 as stated in their report which appears in this Annual Report on Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Changes in Internal Control Over Financial Reporting </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">No change in our internal control over financial reporting occurred during our last fiscal quarter that has materially affected, or is
reasonably likely to materially affect, our internal control over financial reporting. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">95 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_14"></A>ITEM&nbsp;9B.</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 February 12, 2019, Mr. David A. Clark, the President, MEDNAX National Medical Group, of the Company, was appointed as Chief Operating
Officer of the Company. Mr. Clark succeeds Mr. Joseph M. Calabro, the current President and Chief Operating Officer of the Company, who will continue to serve as President of the Company. Mr. Clark, age 52, joined the Company in May 2001 and has
served in various capacities, with executive officer responsibilities from January 1, 2009. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In connection with his appointment as Chief
Operating Officer, Mr. Clark and the Company, through a wholly-owned subsidiary, entered into an Employment Agreement (the &#147;Clark Employment Agreement&#148;) on February 12, 2019, which replaced Mr. Clark&#146;s previous employment agreement
with a wholly-owned subsidiary of the Company. Also on February 12, 2019, the Company, through a wholly-owned subsidiary, entered into an Employment Agreement (the &#147;Andreano Employment Agreement&#148; and, together with the Clark Employment
Agreement, the &#147;Employment Agreements&#148;) with Mr. Dominic J. Andreano, the Senior Vice President, General Counsel and Secretary of the Company, which replaced Mr. Andreano&#146;s previous employment agreement with a wholly-owned subsidiary
of the Company. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Pursuant to the Employment Agreements, each of Mr. Clark and Mr. Andreano will receive an annual base salary as
determined from time to time by his respective supervisor and will be eligible to receive an annual performance bonus in accordance with incentive programs approved from time to time by the Compensation Committee of the Company&#146;s Board of
Directors (the &#147;Compensation Committee&#148;), with a target bonus of 100% of his base salary and a maximum bonus potential of 200% of his base salary. The Employment Agreements also provide for participation in customary Company benefit plans
and incentive compensation plans. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Upon the termination of Mr. Clark&#146;s employment for certain specified reasons, the Clark Employment
Agreement provides for severance payments of up to 12 to 24 months of Mr. Clark&#146;s base salary and a pro rata bonus for the year in which his termination occurs, depending on the basis for termination, plus, in certain cases, the payment of an
amount equal to the greater of (x) 1.5 times the Average Annual Performance Bonus (as defined in the Clark Employment Agreement) and (y) Mr. Clark&#146;s bonus for the year immediately preceding his termination. Upon the termination of Mr.
Andreano&#146;s employment for certain specified reasons, the Andreano Employment Agreement provides for severance payments of up to 12 to 24 months of Mr. Andreano&#146;s base salary and a pro rata bonus for the year in which his termination
occurs, depending on the basis for termination, plus, in certain cases, the payment of an amount equal to the Average Annual Performance Bonus (as defined in the Andreano Employment Agreement). In addition, depending on the basis for termination,
all equity awards granted to Mr. Clark or Mr. Andreano, as applicable, by the Company prior to such termination will become fully vested and, if applicable, exercisable. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Employment Agreements provide for customary protections of the Company&#146;s confidential information and intellectual property and that
Mr. Clark or Mr. Andreano, as applicable, will not, during the term of his employment and for a period of 18, 24 or 30 months thereafter, depending on the basis for termination, compete with the Company, hire away from or solicit to leave the
Company its employees and independent contractors, or interfere in the Company&#146;s relationships with its hospitals, other healthcare facilities, vendors, clients and other third parties. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Employment Agreements have three-year terms and are subject to automatic renewals for successive one-year terms. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The foregoing descriptions of the Clark Employment Agreement and Andreano Employment Agreement are qualified in their entirety by reference to
the terms of the Clark Employment Agreement and Andreano Employment Agreement, copies of which are attached to this Form 10-K as Exhibits 10.37 and 10.35, respectively, and are incorporated herein by reference. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">96 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx671465_14a"></A>PART III </B></P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_15"></A>ITEM&nbsp;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>DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE </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 information required by this Item is incorporated by reference to the applicable information in the definitive proxy statement for our 2019
Annual Meeting of Shareholders, which is to be filed with the SEC within 120 days after our fiscal year end. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_16"></A>ITEM&nbsp;11.</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>EXECUTIVE COMPENSATION </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 information required by this Item is incorporated by reference to the applicable information in the definitive proxy statement for our 2019
Annual Meeting of Shareholders, which is to be filed with the SEC within 120 days after our fiscal year end. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_17"></A>ITEM&nbsp;12.</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>SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS
</B></P></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>SECURITIES AUTHORIZED FOR ISSUANCE UNDER EQUITY COMPENSATION PLANS </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following table provides information as of December&nbsp;31, 2018, with respect to shares of our common stock that may be issued under
existing equity compensation plans, including our Amended and Restated 2008 Incentive Compensation Plan, as amended (&#147;Amended and Restated 2008 Incentive Plan&#148;), our 2004 Incentive Compensation Plan, as amended (&#147;2004 Incentive
Plan&#148;), our ESPP and our SPP. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Equity compensation plans approved by security holders</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">112,976</TD>
<TD NOWRAP VALIGN="bottom">(1)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">27.51</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,574,501</TD>
<TD NOWRAP VALIGN="bottom">(2)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Equity compensation plans not approved by security holders</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">N/A</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">N/A</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">N/A</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Total</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">112,976</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">27.51</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">3,574,501</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">(1)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">All shares are issuable under the Amended and Restated 2008 Incentive Plan, as amended. </P></TD></TR></TABLE>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">(2)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Under the Amended and Restated 2008 Incentive Plan, as amended, 1,997,719 shares remain available for future
issuance, and under the ESPP and the SPP, an aggregate of 1,576,782 shares remain available for future issuance. </P></TD></TR></TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The
remaining information required by this Item is incorporated by reference to the applicable information in the definitive proxy statement for our 2019 Annual Meeting of Shareholders, which is to be filed with the SEC within 120 days after our fiscal
year end. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_18"></A>ITEM&nbsp;13.</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>CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE </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 information required by this Item is incorporated by reference to the applicable information in the definitive proxy statement for our 2019
Annual Meeting of Shareholders, which is to be filed with the SEC within 120 days after our fiscal year end. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">97 </P>


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


<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_19"></A>ITEM&nbsp;14.</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>PRINCIPAL ACCOUNTING FEES AND SERVICES </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 information required by this Item is incorporated by reference to the applicable information in the definitive proxy statement for our 2019
Annual Meeting of Shareholders, which is to be filed with the SEC within 120 days after our fiscal year end. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">98 </P>


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

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx671465_19a"></A>PART IV </B></P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="9%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_20"></A>ITEM&nbsp;15.</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 AND FINANCIAL STATEMENT SCHEDULE </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>(a)(1)&nbsp;&nbsp;&nbsp;&nbsp;Financial Statements </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The information required by this Item is included in Item&nbsp;8 of Part II of this Form 10-K. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>(a)(2)&nbsp;&nbsp;&nbsp;&nbsp;Financial Statement Schedule </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following financial statement schedule for the years ended December&nbsp;31, 2018, 2017 and 2016, is included in this Form 10-K as set
forth below (in thousands). </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx671465_27"></A>Schedule II: Valuation and Qualifying Accounts </B></P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Allowance for contractual adjustments and uncollectibles:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at beginning of year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,286,035</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,224,366</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,129,301</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Amount charged against operating revenue</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8,944,637</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8,285,317</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">7,464,030</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Accounts receivable contractual adjustments and write-offs (net of recoveries)</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(8,741,603</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(8,223,648</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(7,368,965</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Balance at end of year</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,489,069</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,286,035</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,224,366</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1px; ">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">&nbsp;</P></TD>
<TD>&nbsp;</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">All other schedules have been omitted because they are not applicable, not required or the information is
included elsewhere herein. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>(a)(3) Exhibits </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">See Item&nbsp;15(b) of this Form 10-K. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>(b)
Exhibits </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


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


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;&nbsp;&nbsp;2.1</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509000041/dex21.htm">Agreement and Plan of Merger, dated as of December&nbsp;
29, 2008, between MEDNAX, Inc., Pediatrix Medical Group, Inc. and PMG Merger Sub, Inc. (incorporated by reference to Exhibit 2.1 to MEDNAX&#146;s Current Report on Form 8-K dated January&nbsp;2, 2009). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;&nbsp;&nbsp;3.1</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312514045903/d661956dex31.htm">Composite Articles of Incorporation of MEDNAX, Inc. (incorporated by reference to Exhibit 3.1 to MEDNAX&#146;s Annual Report on Form 10-K for the
 period ended December 31, 2013). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;&nbsp;&nbsp;3.2</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312518319651/d651142dex31.htm">Amended and Restated By-laws of MEDNAX, Inc. (incorporated by reference to Exhibit 3.1 to MEDNAX&#146;s Current Report on Form 8-K dated November
 6, 2018). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.1</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312515397783/d32768dex43.htm">Form of 5.25% Senior Notes due 2023 (incorporated by reference to Exhibit A of the First Supplemental Indenture filed as Exhibit 4.3 to MEDNAX&#146;s
 Current Report on Form 8-K dated December&nbsp;8, 2015). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.2</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312518325590/d612902dex43.htm">Form of 6.25% Senior Notes due 2027 (incorporated by reference to Exhibit A of the Fifth Supplemental Indenture filed as Exhibit 4.3 to MEDNAX&#146;s
 Current Report on Form 8-K dated November 13, 2018). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.3</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312515397783/d32768dex42.htm">Indenture, dated as of December 8, 2015, by and between MEDNAX, Inc. and U.S. Bank National Association, as Trustee. (incorporated by reference
 to Exhibit 4.2 to MEDNAX&#146;s Current Report on Form 8-K dated December 8, 2015). </A></TD></TR></TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">99 </P>


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


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


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

<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.4</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312515397783/d32768dex43.htm">First Supplemental Indenture dated as of December 8, 2015 to the Indenture, dated as of December&nbsp;
8, 2015, by and among MEDNAX, Inc., certain of its subsidiaries and U.S. Bank National Association, as Trustee. (incorporated by reference to Exhibit 4.3 to MEDNAX&#146;s Current Report on Form 8-K dated December 8, 2015). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.5</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312518045748/d463027dex104.htm">Second Supplemental Indenture dated as of March 30, 2017 to the Indenture, dated as of December&nbsp;
8, 2015, by and among MEDNAX, Inc., certain of its subsidiaries and U.S. Bank National Association, as Trustee. (incorporated by reference to Exhibit 10.4 to MEDNAX&#146;s Annual Report on Form 10-K for the period ended December 31, 2017).
</A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.6</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312518045748/d463027dex105.htm">Third Supplemental Indenture dated as of November 9, 2017 to the Indenture, dated as of December&nbsp;
8, 2015, by and among MEDNAX, Inc., certain of its subsidiaries and U.S. Bank National Association, as Trustee. (incorporated by reference to Exhibit 10.5 to MEDNAX&#146;s Annual Report on Form 10-K for the year ended December 31, 2017).
</A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.7+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d671465dex107.htm">Fourth Supplemental Indenture dated as of November 13, 2018 to the Indenture, dated as of December 8, 2015, by and among MEDNAX, Inc., certain of its subsidiaries and U.S. Bank National Association, as Trustee.
 </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.8</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312518325590/d612902dex43.htm">Fifth Supplemental Indenture dated as of November 13, 2018 to Indenture, dated as of December 8, 2015, by and among MEDNAX, Inc., certain of its
subsidiaries and U.S. Bank National Association, as Trustee. (incorporated by reference to Exhibit 4.3 to MEDNAX&#146;s Current Report on Form 8-K dated November 13, 2018). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.9</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312517329442/d240444dex101.htm">Credit Agreement, dated as of October 30, 2017, among MEDNAX, Inc., certain of its domestic subsidiaries from time to time party thereto as Guarantors,
the Lender parties thereto, JPMorgan Chase Bank, N.A. as Administrative Agent and Bank of America, N.A., Fifth Third Bank, Mizuho Bank, Ltd., SunTrust Bank, The Bank of Tokyo-Mitsubishi UFJ, Ltd., and Wells Fargo Bank, National Association as
Syndication Agents, and BBVA Compass, Citizens Bank, N.A., PNC Bank, Regions Bank, and U.S. Bank National Association, as Senior Documentation Agents and BB&amp;T as Documentation Agent. JPMorgan Chase Bank, N.A, Fifth Third Bank, Merrill Lynch,
Pierce, Fenner &amp; Smith Incorporated, Mizuho Bank, Ltd., SunTrust Robinson Humphrey, Inc., The Bank of Tokyo-Mitsubishi UFJ, Ltd., and Wells Fargo Securities, LLC, acted as Joint Lead Arrangers and Joint Bookrunners. (incorporated by reference to
Exhibit 10.1 to MEDNAX&#146;s Quarterly Report on Form&nbsp;10-Q for the period ended September 30, 2017). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.10+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d671465dex1010.htm">Amendment No. 1, dated as of November 21, 2018, to the Credit Agreement, dated as of October&nbsp;
30, 2017, among MEDNAX, Inc. certain of its domestic subsidiaries from time to time party thereto as Guarantors, the Lenders parties thereto and JPMorgan Chase Bank, N.A. as Administrative Agent. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.11</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014403009658/g84346exv10w5.txt">Amended and Restated Stock Option Plan of Pediatrix dated as of June 4, 2003 (incorporated by reference to Exhibit 10.5 to Pediatrix&#146;s Quarterly
Report on Form 10-Q for the period ended June&nbsp;30, 2003).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.12</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509000041/dex107.htm">First Amendment, dated December 29, 2008, to Pediatrix Medical Group, Inc. Amended and Restated Stock Option Plan (incorporated by reference to Exhibit
 10.7 to MEDNAX&#146;s Current Report on Form 8-K dated January 2, 2009).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.13</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312515323425/d62915ddef14a.htm#toc62915_54">Amended and Restated MEDNAX, Inc. 1996 Non-Qualified Employee Stock Purchase Plan (incorporated by reference to Exhibit A to MEDNAX&#146;s
 Definitive Proxy Statement on Schedule&nbsp;14A, filed with the SEC on September&nbsp;18, 2015).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.14</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312515323425/d62915ddef14a.htm#toc62915_55">2015 Non-Qualified Stock Purchase Plan of MEDNAX, Inc., dated September 14, 2015 (incorporated by reference to Exhibit B to MEDNAX&#146;s
 Proxy Statement dated September 18, 2015).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.15</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/0001042910-98-000741.txt">Executive Non-Qualified Deferred Compensation Plan of Pediatrix, dated October 13, 1997 (incorporated by reference to Exhibit 10.35 to Pediatrix&#146;s Quarterly
Report on Form 10-Q for the period ended June 30, 1998).* </A></TD></TR></TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">100 </P>


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


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


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

<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.16</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014402011954/g79340exv4w5.txt">Amended and Restated Thrift and Profit Sharing Plan of Pediatrix (incorporated by reference to Exhibit 4.5 to Pediatrix&#146;s Registration Statement
 on Form S-8 (Registration No. 333-101222)).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.17</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014404011924/g92297exv4w3.txt">Pediatrix Medical Group of Puerto Rico Thrift and Profit Sharing Plan (incorporated by reference to Exhibit 4.3 to Pediatrix&#146;s Registration
 Statement on Form S-8 dated December 9, 2004).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.18</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014404003687/x88020def14a.htm">Pediatrix Medical Group, Inc. 2004 Incentive Compensation Plan (incorporated by reference to Exhibit A of Pediatrix&#146;s Proxy Statement on Schedule
 14A dated April 9, 2004).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.19</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509000041/dex108.htm">Second Amendment, dated December 29, 2008, to Pediatrix Medical Group, Inc. 2004 Incentive Compensation Plan (incorporated by reference to Exhibit 10.8
to MEDNAX&#146;s Current Report on Form 8-K dated January 2, 2009).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.20</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312514058946/d679168dex101.htm">MEDNAX, Inc. Amended and Restated 2008 Incentive Compensation Plan, as amended (incorporated by reference to Exhibit 10.1 to MEDNAX&#146;s Current
 Report on Form 8-K dated February 19, 2014).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.21</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014405001776/g93013exv10w3.htm">Pediatrix Medical Group, Inc. Form of Stock Option Agreement for Stock Options Awarded Under the Amended and Restated Stock Option Plan (incorporated
 by reference to Exhibit 10.3 to Pediatrix&#146;s Current Report on Form 8-K dated February 23, 2005).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.22</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014405001776/g93013exv10w4.htm">Pediatrix Medical Group, Inc. Form of Incentive Stock Option Agreement for Incentive Stock Options Awarded Under the 2004 Incentive Compensation
 Plan (incorporated by reference to Exhibit&nbsp;10.4 to Pediatrix&#146;s Current Report on Form 8-K dated February 23, 2005).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.23</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014405001776/g93013exv10w5.htm">Pediatrix Medical Group, Inc. Form of Non-Qualified Stock Option Agreement for Non-Qualified Stock Options Awarded Under the 2004 Incentive Compensation
Plan (incorporated by reference to Exhibit 10.5 to Pediatrix&#146;s Current Report on Form 8-K dated February 23, 2005).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.24</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014405001776/g93013exv10w6.htm">Pediatrix Medical Group, Inc. Form of Restricted Stock Agreement for Restricted Stock Awarded Under the 2004 Incentive Compensation Plan (incorporated
 by reference to Exhibit 10.6 to Pediatrix&#146;s Current Report on Form 8-K dated February 23, 2005).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.25</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509040133/dex1017.htm">MEDNAX, Inc. Form of Non-Qualified Stock Option Agreement for Non-Qualified Stock Options Awarded Under the 2008 Incentive Compensation Plan (incorporated
 by reference to Exhibit 10.17 to MEDNAX&#146;s Annual Report on Form 10-K for the year ended December 31, 2008).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.26</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509040133/dex1018.htm">MEDNAX, Inc. Form of Restricted Stock Agreement for Restricted Stock Awarded Under the 2008 Incentive Compensation Plan (incorporated by reference to
 Exhibit 10.18 to MEDNAX&#146;s Annual Report on Form 10-K for the year ended December 31, 2008).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.27</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312511217054/dex101.htm">Employment Agreement, dated August 7, 2011, by and between MEDNAX Services, Inc. and Roger J. Medel, M.D. (incorporated by reference to Exhibit 10.1
 to MEDNAX&#146;s Current Report on <FONT STYLE="white-space:nowrap">Form&nbsp;8-K</FONT> dated August 10, 2011).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.28</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312517303517/d470111dex101.htm">First Amendment to Employment Agreement, dated October 4, 2017, by and between MEDNAX Services, Inc. and Roger J. Medel, M.D. (incorporated by
reference to Exhibit 10.1 to MEDNAX&#146;s Current Report on Form 8-K dated October 4, 2017).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.29</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312508182974/dex102.htm">Employment Agreement, dated August 20, 2008, by and between Pediatrix Medical Group, Inc. and Joseph M. Calabro (incorporated by reference to Exhibit
 10.2 to Pediatrix&#146;s Current Report on Form&nbsp;8-K dated August 22, 2008).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.30</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312509000041/dex103.htm">Amendment Agreement, dated December 29, 2008, between MEDNAX, Inc., Pediatrix Medical Group, Inc. and Joseph M. Calabro (incorporated by reference to
Exhibit 10.3 to MEDNAX&#146;s Current Report on Form 8-K dated January 2, 2009).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.31</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312510040811/dex1028.htm">Employment Agreement, dated February 24, 2010, by and between MEDNAX Services, Inc. and Vivian Lopez-Blanco (incorporated by reference to Exhibit 10.28
to MEDNAX&#146;s Annual Report on Form&nbsp;10-K for the year ended December 31, 2009).* </A></TD></TR></TABLE>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">101 </P>


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


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


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

<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.32</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312518045748/d463027dex1028.htm">Employment Agreement, dated February 12, 2018, by and between MEDNAX Services, Inc. and Vivian Lopez-Blanco (incorporated by reference to Exhibit
 10.28 to MEDNAX&#146;s Annual Report on Form 10-K for the year ended December 31, 2017).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.33</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312518260694/d616849dex101.htm">Employment Agreement, dated August 22, 2018, by and between MEDNAX Services, Inc. and Stephen Farber (incorporated by reference to Exhibit 10.1
 to MEDNAX&#146;s Current Report on Form 8-K dated August 28, 2018).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.34</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312518045748/d463027dex1029.htm">Employment Agreement, dated February 12, 2018, by and between MEDNAX Services, Inc. and Dominic J. Andreano (incorporated by reference to Exhibit
 10.29 to MEDNAX&#146;s Annual Report on Form 10-K for the year ended December 31, 2017).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.35+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d671465dex1035.htm">Employment Agreement, dated February 12, 2019, by and between MEDNAX Services, Inc. and Dominic J. Andreano.* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.36</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312518045748/d463027dex1030.htm">Employment Agreement, dated February 12, 2018, by and between MEDNAX Services, Inc. and David A. Clark (incorporated by reference to Exhibit
 10.30 to MEDNAX&#146;s Annual Report on Form 10-K for the year ended December 31, 2017).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.37+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d671465dex1037.htm">Employment Agreement, dated February 12, 2019, by and between MEDNAX Services, Inc. and David A. Clark.* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.38</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312511217054/dex102.htm">Restricted Shares Units Agreement for Roger J. Medel, M.D. dated August 7, 2011 (incorporated by reference to Exhibit 10.2 to MEDNAX&#146;s Current Report
 on Form 8-K dated August 10, 2011).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.39</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000095014404002417/g87662exv10w6.txt">Form of Indemnification Agreement between Pediatrix and each of its directors and executive officers. (incorporated by reference to Exhibit 10.6
to Pediatrix&#146;s Annual Report on Form 10-K for the year ended December 31, 2003).* </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.40</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312512089192/d255020dex1031.htm">Form of Exclusive Management and Administrative Services Agreement with affiliated professional contractors (incorporated by reference to Exhibit
 10.31 to MEDNAX&#146;s Annual Report on Form 10-K for the year ended December 31, 2011). </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;10.41</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="http://www.sec.gov/Archives/edgar/data/893949/000119312518315785/d613941dex101.htm">Confirmation<B>&#151;</B>Uncollared Accelerated Share Repurchase dated August 31, 2018 between Bank of America, N.A. and MEDNAX, Inc. (incorporated
 by reference to Exhibit 10.1 to MEDNAX&#146;s Quarterly Report on Form 10-Q for the period ended September 30, 2018).** </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;21.1+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d671465dex211.htm">Subsidiaries of the Registrant. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;23.1+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d671465dex231.htm">Consent of PricewaterhouseCoopers LLP. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;31.1+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d671465dex311.htm">Certification of Chief Executive Officer pursuant to Securities Exchange Act Rule 13a-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;31.2+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d671465dex312.htm">Certification of Chief Financial Officer pursuant to Securities Exchange Act Rule 13a-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002. </A></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>&nbsp;&nbsp;32+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d671465dex32.htm">Certification pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 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="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">102 </P>


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

 <P STYLE="line-height:8.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1px solid #000000;width:10%">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">*</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Management contracts or compensation plans, contracts or arrangements. </P></TD></TR></TABLE>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">**</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Certain confidential material contained in the document has been omitted and filed separately with the
Securities and Exchange Commission. Confidential treatment has been granted with respect to this omitted information. </P></TD></TR></TABLE>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left">+</TD>
<TD ALIGN="left" VALIGN="top"> <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="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="10%" VALIGN="top" ALIGN="left"><B><A NAME="tx671465_21"></A>ITEM&nbsp;16.</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>FORM 10-K SUMMARY </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">None. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">103 </P>


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

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


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


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>MEDNAX, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">Date: February&nbsp;14, 2019</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">By:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Roger J. Medel, M.D.</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Roger J. Medel, M.D.</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Chief Executive Officer</P></TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the
following persons on behalf of the registrant in the capacities and on the dates indicated. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


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


<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Roger J. Medel, M.D.</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Roger J. Medel, M.D.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">Chief Executive Officer</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">(Principal Executive Officer)</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2019</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Stephen D. Farber</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Stephen D. Farber</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">Chief Financial Officer</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">(Principal Financial Officer)</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2019</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ John C. Pepia</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">John C. Pepia</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">Chief Accounting Officer</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">(Principal Accounting Officer)</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2019</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Cesar L. Alvarez</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Cesar L. Alvarez</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director and Chairman of the Board</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2019</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Manuel Kadre</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Manuel Kadre</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Lead Independent Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2019</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Karey D. Barker</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Karey D. Barker</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2019</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Waldemar A. Carlo, M.D.</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Waldemar A. Carlo, M.D.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2019</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Michael B. Fernandez</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Michael B. Fernandez</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2019</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Paul G. Gabos</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Paul G. Gabos</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2019</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Pascal J. Goldschmidt, M.D.</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Pascal J. Goldschmidt, M.D.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2019</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:0pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ Enrique J. Sosa, Ph.D.</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">Enrique J. Sosa, Ph.D.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top" ALIGN="center">Director</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" NOWRAP ALIGN="center">February&nbsp;14, 2019</TD></TR>
</TABLE> <P STYLE="font-size:18pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</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">104 </P>

</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-10.7
<SEQUENCE>2
<FILENAME>d671465dex107.htm
<DESCRIPTION>EX-10.7
<TEXT>
<HTML><HEAD>
<TITLE>EX-10.7</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 10.7 </B></P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MEDNAX, INC. </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>TO
</B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>U.S. BANK NATIONAL ASSOCIATION, </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>as Trustee </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>GUARANTEED
TO THE EXTENT SET FORTH HEREIN BY OBSTETRIX MEDICAL GROUP </B></P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>OF NEW JERSEY, P.C. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FOURTH SUPPLEMENTAL INDENTURE </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Dated as of November&nbsp;13, 2018 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>to the </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>INDENTURE
</B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Dated as of December&nbsp;8, 2015 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>GUARANTEES OF 5.25% SENIOR NOTES DUE 2023 </B></P>
</DIV></Center>


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


<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>FOURTH SUPPLEMENTAL INDENTURE </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>5.25% Senior Notes due 2023 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">THIS FOURTH SUPPLEMENTAL INDENTURE, dated as of November&nbsp;13, 2018 (this &#147;<B>Fourth Supplemental Indenture</B>&#148;), by and among
MEDNAX, INC., a Florida Corporation (the &#147;<B>Company</B>&#148;), Obstetrix Medical Group of New Jersey, P.C. (the &#147;<B>Guarantor</B>&#148;), and U.S. Bank National Association, a national banking association, as Trustee hereunder (the
&#147;<B>Trustee</B>&#148;). </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>RECITALS OF THE COMPANY: </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, the Company and the Trustee have heretofore entered into an Indenture dated as of December&nbsp;8, 2015 (the &#147;<B>Base
Indenture</B>&#148;), as supplemented by the First Supplemental Indenture, dated as of December&nbsp;8, 2015 (the &#147;<B>First Supplemental Indenture</B>&#148;), the Second Supplemental Indenture, dated as of March&nbsp;30, 2017 (the
&#147;<B>Second Supplemental Indenture</B>&#148;), the Third Supplemental Indenture, dated as of November&nbsp;9, 2017 (the &#147;<B>Third Supplemental Indenture</B>&#148; and, together with the Base Indenture, First Supplemental Indenture, the
Second Supplemental Indenture and this Fourth Supplemental Indenture, the &#147;<B>Indenture</B>&#148;) providing for the issuance by the Company of $750,000,000 aggregate principal amount of its 5.25% Senior Notes due 2023 (together with the
Guarantees thereof, the &#147;<B>Notes</B>&#148;); </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, Section&nbsp;4.04 of the First Supplemental Indenture provides that if the
Company or any of its Subsidiaries acquires or creates another Subsidiary after the Issue Date that provides a guarantee of the Company&#146;s obligations under any Debt Facility (including the New Credit Agreement (hereinafter defined)) with an
aggregate principal or committed amount of $250&nbsp;million or more, then, within 10 Business Days after such Subsidiary provides such guarantee, such newly acquired or created Subsidiary shall execute a supplemental indenture pursuant to which it
will unconditionally Guarantee, on a joint and several basis, payment of principal of, premium, if any, and interest in respect of the Notes on a senior unsecured basis on the same terms and conditions as those set forth in the First Supplemental
Indenture; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, the Guarantor is a newly acquired or created Subsidiary of the Company and has provided a guarantee of the
Company&#146;s obligations under that certain Credit Agreement, dated as of October&nbsp;30, 2017, by and among the Company, the guarantors party thereto, JPMorgan Chase Bank, N.A., in its capacity as administrative agent and the lenders party
thereto (the &#147;<B>Credit Agreement</B>&#148;); </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, Section&nbsp;6.01 of the First Supplemental Indenture provides that the
Company, the Guarantors, if applicable, and the Trustee may modify and amend the Indenture, the Notes or the Guarantees of the Notes without the consent of any Holder to allow any Guarantor to execute a supplemental indenture and/or a Guarantee of
the Notes; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, the Board of Directors of the Company and the governing body of the Guarantor has duly authorized the execution and
delivery of this Fourth Supplemental Indenture; and </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">WHEREAS, all acts and things necessary to make this Fourth Supplemental Indenture a
valid agreement of each of the Company and the Guarantor according to its terms have been done and performed. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">1 </P>

</DIV></Center>


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


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


<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>ARTICLE II </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>GUARANTEES </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.01.&nbsp;&nbsp;&nbsp;&nbsp;<U>Guarantee</U>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;Subject to this Article II, the Guarantor hereby unconditionally guarantees on an unsecured, unsubordinated basis,
to each Holder of a Note, authenticated and delivered by the Trustee, and to the Trustee and its successors and assigns, irrespective of the validity and enforceability of this Fourth Supplemental Indenture, the Third Supplemental Indenture, the
Second Supplemental Indenture, the First Supplemental Indenture or the Base Indenture, the Notes or the obligations of the Company hereunder or thereunder, that: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i)&nbsp;&nbsp;&nbsp;&nbsp;the principal of, premium, if any, and interest on, the Notes will be promptly paid in full when
due, whether at maturity, by acceleration or otherwise, and interest on the overdue principal and interest on the Notes, if any, if lawful, and all other obligations of the Company to the Holders or the Trustee hereunder or thereunder will be
promptly paid in full or performed, all in accordance with the terms hereof and thereof; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii)&nbsp;&nbsp;&nbsp;&nbsp;in case of any extension of time of payment or renewal of any Notes or any of such other
obligations, that same will be promptly paid in full when due or performed in accordance with the terms of the extension or renewal, whether at Stated Maturity, by acceleration or otherwise. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Failing payment when due of any amount so guaranteed or any performance so guaranteed for any reason whatsoever, the Guarantor shall be obligated to pay the
same immediately. The Guarantor agrees that this is a guarantee of payment and not a guarantee of collection. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;The Guarantor hereby agrees that its obligations hereunder are unconditional, irrespective of the validity,
regularity or enforceability of this Fourth Supplemental Indenture, the Third Supplemental Indenture, the Second Supplemental Indenture, the First Supplemental Indenture, or the Base Indenture, the Notes, the absence of any action to enforce the
same, any waiver or consent by any Holder of the Notes with respect to any provisions hereof or thereof, the recovery of any judgment against the Company, any action to enforce the same or any other circumstance which might otherwise constitute a
legal or equitable discharge or defense of a Guarantor. The Guarantor hereby waives diligence, presentment, demand of payment, filing of claims with a court in the event of bankruptcy or insolvency of the Company, any right to require a proceeding
first against the Company, protest, notice and all demands whatsoever and covenant that this Guarantee will not be discharged except by complete performance of the obligations contained in the Notes and the Indenture. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(b)&nbsp;&nbsp;&nbsp;&nbsp;If any Holder or the Trustee is required by any court or otherwise to return to the Company, the Guarantor or any
custodian, trustee, liquidator or other similar official acting in relation to either the Company or the Guarantor, any amount paid either to the Trustee or such Holder, this Guarantee, to the extent theretofore discharged, shall be reinstated in
full force and effect. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(c)&nbsp;&nbsp;&nbsp;&nbsp;The Guarantor agrees that it shall not be entitled to any right of subrogation in
relation to the Holders in respect of any obligations guaranteed hereby until payment in full of all obligations under the Notes guaranteed hereby. The Guarantor further agrees that, as between the Guarantor, on the one hand, and the Holders and the
Trustee, on the other hand, (1)&nbsp;the maturity of the obligations guaranteed hereby may be accelerated as provided in Article V of the First Supplemental Indenture for the purposes of this Guarantee, notwithstanding any stay, injunction or other
prohibition preventing such acceleration in respect of the obligations guaranteed hereby, and (2)&nbsp;in the event of any declaration of acceleration of such obligations as provided in Article V of the First Supplemental Indenture, such obligations
(whether or not due and payable) will forthwith become due and payable by the Guarantor for purposes of this Guarantee. The Guarantor will have the right to seek contribution from any other Guarantor, or the Company, as the case may be, so long as
the exercise of such right does not impair the rights of the Holders under this Guarantee. </P>
 <p STYLE="margin-top: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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.02.&nbsp;&nbsp;&nbsp;&nbsp;<U>Limitation on Guarantor Liability</U>. The
Guarantor, and by its acceptance of the Notes, each Holder, hereby confirms that it is the intention of all such parties that the Guarantee of such Guarantor of the Notes not constitute a fraudulent transfer, fraudulent conveyance or fraudulent
obligation for purposes of Bankruptcy Law, the Uniform Fraudulent Conveyance Act, the Uniform Fraudulent Transfer Act or any similar federal or state law to the extent applicable to any Guarantee of the Notes. To effectuate the foregoing intention,
the Trustee, the Holders and the Guarantor hereby irrevocably agree that the obligations of such Guarantor shall be limited to the maximum amount that shall, after giving effect to such maximum amount and all other contingent and fixed liabilities
of such Guarantor that are relevant under such laws, and after giving effect to any collections from, rights to receive contributions from or payments made by or on behalf of any other Guarantor in respect of the obligations of such other Guarantor
under this Article II that are relevant under such laws, result in the obligations of such Guarantor under its Guarantee of the Notes not constituting a fraudulent transfer, fraudulent conveyance or fraudulent obligation. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.03.&nbsp;&nbsp;&nbsp;&nbsp;<U>Execution and Delivery of Guarantees</U>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;To evidence its Guarantee as set forth in Section&nbsp;2.01 hereof, the Guarantor hereby agrees that this Fourth
Supplemental Indenture shall be executed on behalf of such Guarantor by one of its authorized officers or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">attorneys-in-fact.</FONT></FONT> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(b)&nbsp;&nbsp;&nbsp;&nbsp;The Guarantor hereby agrees that its Guarantee set forth in Section&nbsp;2.01 hereof shall remain in full force and
effect notwithstanding the absence of the endorsement of any notation of such Guarantee. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.04.&nbsp;&nbsp;&nbsp;&nbsp;<U>Contribution</U>. The Guarantor that makes a payment or distribution under its Guarantee of the
Notes shall be entitled to contribution from any other Guarantor or the Company, as the case may be. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.05.&nbsp;&nbsp;&nbsp;&nbsp;<U>Releases</U>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a)&nbsp;&nbsp;&nbsp;&nbsp;The Guarantee of the Notes by a Guarantor will be automatically and unconditionally released, and any Person
acquiring assets (including by way of merger or consolidation) or Capital Stock of a Guarantor shall not be required to assume the obligations of any such Guarantor: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(1)&nbsp;&nbsp;&nbsp;&nbsp;in connection with any sale, exchange, transfer, conveyance or other disposition of (whether by
merger, consolidation or the sale of) a majority of the Capital Stock of such Guarantor (or such lesser portion as is sufficient for such Guarantor to cease to be a Subsidiary of the Company) or the sale of all or substantially all the assets of
such Guarantor, to or with and into a Person which is not the Company or another Subsidiary of the Company; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(2)&nbsp;&nbsp;&nbsp;&nbsp;if any Guarantor is dissolved or otherwise no longer obligated to provide a Guarantee of the Notes
pursuant to the Indenture; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(3)&nbsp;&nbsp;&nbsp;&nbsp;if such Guarantor&#146;s guarantee of any obligations under any Debt
Facility of the Company (including the Credit Agreement) with an aggregate principal or committed amount of $250&nbsp;million or more is fully and unconditionally released, except that such Guarantor shall subsequently be required to become a
Guarantor by executing a supplemental indenture and providing the Trustee with an Officers&#146; Certificate and Opinion of Counsel as required by the Indenture at such time as it guarantees any obligations under any Debt Facility of the Company
(including the Credit Agreement) with an aggregate principal or committed amount of $250&nbsp;million or more; or </P>
 <p STYLE="margin-top: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">


<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">(4)&nbsp;&nbsp;&nbsp;&nbsp;upon the Company&#146;s exercise of its legal
defeasance option or covenant defeasance option as described in Section&nbsp;12.02 or Section&nbsp;12.03 of the First Supplemental Indenture or if the Company&#146;s obligations under the Indenture and the Notes are discharged in accordance with
Section&nbsp;12.01 of the First Supplemental Indenture. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(b)&nbsp;&nbsp;&nbsp;&nbsp;The Trustee shall execute any documents reasonably
requested by either the Company or a Guarantor in order to evidence the release of such Guarantor from its obligations under its Guarantee under this Article II, subject to the Trustee&#146;s receipt of an Opinion of Counsel and Officers&#146;
Certificate stating that all conditions precedent to such release have been met. </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE III </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MISCELLANEOUS PROVISIONS </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.01.&nbsp;&nbsp;&nbsp;&nbsp;<U>Ratification of Indenture</U>. Except as expressly modified or amended hereby, the Indenture
continues in full force and effect and is in all respects confirmed, ratified and preserved and the provisions thereof shall be applicable to the Notes and this Fourth Supplemental Indenture. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.02.&nbsp;&nbsp;&nbsp;&nbsp;<U>Provisions Binding on Company</U><U>&#146;</U><U>s Successors</U>. All the covenants,
stipulations, promises and agreements of the Company contained in this Fourth Supplemental Indenture shall bind its successors and assigns whether so expressed or not. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.03.&nbsp;&nbsp;&nbsp;&nbsp;<U>Official Acts by Successor Corporation</U>. Any act or proceeding by any provision of this Fourth
Supplemental Indenture authorized or required to be done or performed by any board, committee or officer of the Company shall and may be done and performed with like force and effect by the like board, committee or officer of any corporation or
entity that shall at the time be the lawful sole successor of the Company. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.04.&nbsp;&nbsp;&nbsp;&nbsp;<U>Addresses for
Notices, Etc</U>. Any notice or demand which by any provision of this Fourth Supplemental Indenture is required or permitted to be given or served by the Trustee or by the Noteholders on the Company or the Guarantor shall be deemed to have been
sufficiently given or made, for all purposes if given or served by being deposited postage prepaid by registered or certified mail in a post office letter box addressed (until another address is filed by the Company with the Trustee) to the Company
at 1301 Concord Terrace, Sunrise, Florida 33323, Attention: General Counsel. Any notice, direction, request or demand hereunder to or upon the Trustee shall be deemed to have been sufficiently given or made, for all purposes, if given or served by
being deposited postage prepaid by registered or certified mail in a post office letter box addressed to U.S. Bank National Association at 1349 W. Peachtree Street, Suite 1050, Atlanta, Georgia 30309, Attention: George Hogan. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Trustee, by notice to the Company, may designate additional or different addresses for subsequent notices or communications. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Any notice or communication mailed to a Noteholder shall be mailed to him by first class mail, postage prepaid, at his address as it appears
on the Security Register and shall be sufficiently given to him if so mailed within the time prescribed. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Failure to mail a notice or
communication to a Noteholder or any defect in it shall not affect its sufficiency with respect to other Noteholders. If a notice or communication is mailed in the manner provided above, it is duly given, whether or not the addressee receives it.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.05.&nbsp;&nbsp;&nbsp;&nbsp;<U>Governing Law</U>. THIS FOURTH SUPPLEMENTAL INDENTURE SHALL BE GOVERNED BY AND CONSTRUED IN
ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK WITHOUT REGARD TO CONFLICT OF LAWS PRINCIPLES OF SUCH STATE OTHER THAN NEW YORK GENERAL OBLIGATIONS LAW SECTION <FONT STYLE="white-space:nowrap">5-1401.</FONT> THIS
</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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
FOURTH SUPPLEMENTAL INDENTURE IS SUBJECT TO THE PROVISIONS OF THE TIA THAT ARE REQUIRED TO BE A PART OF THIS FOURTH SUPPLEMENTAL INDENTURE AND SHALL, TO THE EXTENT APPLICABLE, BE GOVERNED BY SUCH
PROVISIONS. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.06.&nbsp;&nbsp;&nbsp;&nbsp;<U>Benefits of Indenture</U>. Nothing in the Indenture or in the Notes, expressed
or implied, shall give to any person, other than the parties hereto, any Paying Agent, any authenticating agent, any Security Registrar and their successors hereunder, the Noteholders, any benefit or any legal or equitable right, remedy or claim
under the Indenture. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.07.&nbsp;&nbsp;&nbsp;&nbsp;<U>Headings, Etc</U>. The titles and headings of the articles and sections
of this Fourth Supplemental Indenture have been inserted for convenience of reference only, are not to be considered a part hereof, and shall in no way modify or restrict any of the terms or provisions hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.08.&nbsp;&nbsp;&nbsp;&nbsp;<U>Counterparts</U>. This Fourth Supplemental Indenture may be executed and delivered in any number
of counterparts, each of which when so executed and delivered shall be deemed to be an original, and all such counterparts shall together constitute but one and the same instrument. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.09.&nbsp;&nbsp;&nbsp;&nbsp;<U>Trustee</U>. The Trustee makes no representations as to the validity or sufficiency of this
Fourth Supplemental Indenture. The statements and recitals herein are deemed to be those of the Company and not of the Trustee. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.10.&nbsp;&nbsp;&nbsp;&nbsp;<U>Further Instruments and Acts</U>. Upon request of the Trustee, the Company will execute and
deliver such further instruments and do such further acts as may be reasonably necessary or proper to carry out more effectively the purposes of this Fourth Supplemental Indenture. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.11.&nbsp;&nbsp;&nbsp;&nbsp;<U>Waiver of Jury Trial</U>. EACH OF THE COMPANY, THE GUARANTOR AND THE TRUSTEE HEREBY IRREVOCABLY
WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, ANY AND ALL RIGHT TO TRIAL BY JURY IN ANY LEGAL PROCEEDING ARISING OUT OF OR RELATING TO THE INDENTURE, THE NOTES OR THE TRANSACTION CONTEMPLATED HEREBY. </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><I>[Remainder of page left intentionally blank] </I></B></P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">6 </P>

</DIV></Center>


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


<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>IN WITNESS WHEREOF</B>, the parties hereto have caused this Fourth Supplemental Indenture to be duly
executed by their respective officers hereunto duly authorized, all as of the day and year first above written. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">COMPANY: </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="12%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="87%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<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></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<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/ Dominic J. Andreano</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">Name:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">Title:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">General Counsel and Secretary</TD></TR></TABLE></DIV> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">TRUSTEE: </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="12%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="87%"></TD></TR>

<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom" COLSPAN="3"><B>U.S. BANK NATIONAL ASSOCIATION,</B></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="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/ George Hogan</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">Name:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">George Hogan</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">Title:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Vice-President</TD></TR></TABLE></DIV> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">GUARANTOR: </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></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="99%"></TD></TR>

<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom" COLSPAN="3"> <P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman"><B>OBSTETRIX MEDICAL GROUP OF NEW
JERSEY,&nbsp;P.C.</B>,&nbsp;a&nbsp;New&nbsp;Jersey&nbsp;professional&nbsp;corporation</P></TD></TR></TABLE></DIV> <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="12%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="87%"></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="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/ Dominic J. Andreano</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">Name:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">Title:</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">Attorney-in-Fact</FONT></FONT></TD></TR>
</TABLE></DIV>
</DIV></Center>

</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-10.10
<SEQUENCE>3
<FILENAME>d671465dex1010.htm
<DESCRIPTION>EX-10.10
<TEXT>
<HTML><HEAD>
<TITLE>EX-10.10</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 10.10 </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="right">Execution Version </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><U>AMENDMENT&nbsp;NO.&nbsp;1&nbsp;TO CREDIT AGREEMENT </U></B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">AMENDMENT NO. 1 dated as of November&nbsp;21, 2018 (this &#147;<U>Amendment</U>&#148;), to the Credit Agreement, dated as of October&nbsp;30,
2017 (as amended, modified, extended, restated, replaced, or supplemented from time to time in accordance with its terms prior to the date hereof, the &#147;<U>Credit Agreement</U>&#148;), among <B>MEDNAX, INC.</B>, a Florida corporation (the
&#147;<U>Borrower</U>&#148;), the Guarantors party thereto, the Lenders and <B>JPMORGAN CHASE BANK, N.A.</B>, as administrative agent (the &#147;<U>Administrative Agent</U>&#148;), by and among the Borrower, the Guarantors, the Lenders party hereto
and the Administrative Agent. Terms defined in the Amended Credit Agreement (as defined below) and used herein shall have the meanings given to them in the Amended Credit Agreement unless otherwise defined herein. </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><U>W</U> <U>I</U> <U>T</U> <U>N</U> <U>E</U> <U>S</U> <U>S</U> <U>E</U> <U>T</U> <U>H</U>: </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">WHEREAS, the Borrower has requested certain amendments to the Credit Agreement; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">WHEREAS, the Administrative Agent, the Borrower and the Lenders party hereto, constituting at least the Required Lenders, are willing to so
agree pursuant to Section&nbsp;9.1 of the Credit Agreement, subject to the terms and conditions set forth in this Amendment; and </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">WHEREAS,
JPMorgan Chase Bank, N.A. is acting as the lead &#147;left&#148; arranger and bookrunner of this Amendment (in such capacity, the &#147;<U>Amendment Lead Arranger</U>&#148;). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">NOW, THEREFORE, the parties hereto hereby agree as follows: </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">ARTICLE I </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><U>Required Lender
Amendments to Credit Agreement </U></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman"><U>Section</U><U></U><U>&nbsp;1.1.</U> The Existing Credit Agreement is, effective as of the Amendment
No.&nbsp;1 Effective Date, hereby amended to delete the stricken text (indicated textually in the same manner as the following example: <STRIKE>stricken text</STRIKE>) and to add the double-underlined text (indicated textually in the same manner as
the following example: <U STYLE="border-bottom:1pt double; padding-bottom:1pt">double-underlined text</U>) as set forth in the pages attached as <U>Exhibit A</U> hereto (as amended, the &#147;<U>Amended Credit Agreement</U>&#148;). </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">ARTICLE II </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><U>Conditions to
Effectiveness </U></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman"><U>Section</U><U></U><U>&nbsp;2.1.</U> <U>Effective Date</U>. This Amendment shall become effective on the date (the
&#147;<U>Amendment No.</U><U></U><U>&nbsp;1 Effective Date</U>&#148;) on which: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) The Administrative Agent shall have
received counterparts to this Amendment duly executed and delivered by the Borrower, each Guarantor, the Administrative Agent and the Required Lenders. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) The Borrower shall have paid (i)&nbsp;all fees due and payable on the Amendment No.&nbsp;1 Effective Date under the fee
letter, dated November&nbsp;16, 2018, among the Borrower and the Amendment Lead Arranger and (ii)&nbsp;all reasonable and documented <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> fees and expenses
incurred by the Administrative Agent and the Amendment Lead Arranger (including the reasonable and documented expenses of Cahill Gordon&nbsp;&amp; Reindel LLP, counsel to the Administrative Agent and the Amendment Lead Arranger) for which invoices
have been presented at least two (2)&nbsp;Business Days prior to the Amendment No.&nbsp;1 Effective Date. </P>
</DIV></Center>


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


<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">(c) The Administrative Agent shall have received customary evidence of
authorization of the transactions described herein, valid organization and good standing (or applicable equivalent) in the jurisdiction of organization, in each case, with respect to the Borrower and each Guarantor, and officer&#146;s certificates
related thereto (which shall include an incumbency certificate), substantially in the form delivered on the Closing Date pursuant to <U>Section</U><U></U><U>&nbsp;4.1(b)</U> of the Credit Agreement. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) The Administrative Agent shall have received the opinion of Greenberg Traurig, P.A. with respect to the Borrower in form
and substance reasonably satisfactory to the Administrative Agent. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) (i) The representations and warranties of each
Credit Party set forth in <U>Section</U><U></U><U>&nbsp;3</U> below are true and correct on and as of the Amendment No.&nbsp;1 Effective Date and (ii)&nbsp;as of the date hereof, no Default or Event of Default has occurred and is continuing. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) The Administrative Agent shall have received a certificate signed by the President, a Vice President or a Financial Officer
of the Borrower certifying as to the satisfaction of the condition set forth in paragraph (e)&nbsp;of this <U>Section</U><U></U><U>&nbsp;2.1</U> as of the Amendment No.&nbsp;1 Effective Date. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(g) To the extent reasonably requested by the Administrative Agent, and in such case reasonably satisfactory to the
Administrative Agent, either (i)&nbsp;such affidavits relative to the execution and delivery of any Credit Document as required to support the determination that no Florida documentary stamp taxes are required to be paid or (ii)&nbsp;evidence of
payment by the Borrower of any Florida documentary stamp taxes applicable to the execution and delivery of the Credit Documents. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(h) At least three (3)&nbsp;Business Days prior to the Amendment No.&nbsp;1 Effective Date, to the extent reasonably requested
in writing by the Administrative Agent at least ten (10)&nbsp;Business Days prior to the Amendment No.&nbsp;1 Effective Date, the Administrative Agent shall have received such information reasonably requested by the Lenders in connection with
applicable &#147;know your customer&#148; rules and regulations, including the PATRIOT Act. </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">ARTICLE III </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><U>Representation and Warranties </U></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman"><U>Section</U><U></U><U>&nbsp;3.1.</U> The Borrower hereby represents and warrants as of the Amendment No.&nbsp;1 Effective Date that this
Amendment has been, or when executed and delivered will be, duly executed and delivered by the Borrower. Neither the execution and delivery of this Amendment, nor the consummation of the transactions herein contemplated, nor performance of and
compliance with the terms and provisions herein and thereof, by the Borrower will (a)&nbsp;violate in any material respect any Requirement of Law (except those as to which waivers or consents have been obtained), (b)&nbsp;conflict with, result in a
breach of or constitute a default under (i)&nbsp;the articles of incorporation, bylaws, articles of organization, operating agreement or other organization documents of the Credit Parties or (ii)&nbsp;any Material Contract to which such Person is a
party or by which any of its properties may be bound or any material approval or material consent from any Governmental Authority relating to such Person (except those as to which waivers or consents have been obtained) which conflict, breach or
default in any such case in this clause (ii)&nbsp;could reasonably be expected to have a Material Adverse Effect, or (c)&nbsp;result in, or require, </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">-2- </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
the creation or imposition of any Lien on any Credit Party&#146;s properties or revenues pursuant to any Requirement of Law, the articles of incorporation, bylaws, articles of organization,
operating agreement or other organization documents of such Credit Party or Contractual Obligation other than the Liens arising under or contemplated in connection with the Credit Documents or Permitted Liens. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman"><U>Section</U><U></U><U>&nbsp;3.2.</U> The representations and warranties contained in Article III of the Amended Credit Agreement
(A)&nbsp;with respect to representations and warranties that contain a materiality qualification, are true and correct and (B)&nbsp;with respect to representations and warranties that do not contain a materiality qualification, are true and correct
in all material respects, in each case as of the Amendment No.&nbsp;1 Effective Date as if made on and as of such date except for any representation or warranty made as of an earlier date, which representation and warranty shall remain true and
correct (subject to the applicable materiality threshold in the preceding clauses (A)&nbsp;or (B)) as of such earlier date. </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">ARTICLE IV
</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><U>Miscellaneous </U></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman"><U>Section</U><U></U><U>&nbsp;4.1.</U> <U>Counterparts</U>. This Amendment may be executed in any number of counterparts and by different
parties hereto on separate counterparts, each of which when so executed and delivered shall be deemed to be an original, but all of which when taken together shall constitute a single instrument. Delivery of an executed counterpart of a signature
page of this Amendment by facsimile or other electronic transmission shall be effective as delivery of a manually executed counterpart hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman"><U>Section</U><U></U><U>&nbsp;4.2.</U> <U>Reaffirmation</U>. Each of the undersigned Guarantors (each, a &#147;<U>Reaffirming Party</U>&#148;)
hereby acknowledges the Amendment and the transactions contemplated thereby. Each Reaffirming Party hereby reaffirms all obligations and liabilities of such Reaffirming Party under the Loan Documents to which it is a party, as such obligations and
liabilities have been amended by this Amendment, and confirms that such obligations and liabilities shall continue to be in full force and effect and shall continue to apply to the Credit Agreement and each other Loan Document. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman"><U>Section</U><U></U><U>&nbsp;4.3.</U> <U>Applicable Law</U>. THIS AMENDMENT AND THE RIGHTS AND OBLIGATIONS OF THE PARTIES HEREUNDER SHALL BE
GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK WITHOUT REGARD TO ITS CONFLICTS OF LAW PRINCIPLES THAT WOULD CAUSE THE LAW OF ANOTHER JURISDICTION TO APPLY (OTHER THAN SECTIONS
<FONT STYLE="white-space:nowrap">5-1401</FONT> AND <FONT STYLE="white-space:nowrap">5-1402</FONT> OF THE NEW YORK GENERAL OBLIGATIONS LAW). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman"><U>Section</U><U></U><U>&nbsp;4.4.</U> <U>JURY WAIVER</U>. EACH PARTY TO THIS AMENDMENT HEREBY EXPRESSLY WAIVES ANY RIGHT TO TRIAL BY JURY OF
ANY CLAIM, DEMAND, ACTION OR CAUSE OF ACTION ARISING UNDER THIS AMENDMENT OR IN ANY WAY CONNECTED WITH OR RELATED TO THIS AMENDMENT, OR THE TRANSACTIONS RELATED THERETO, IN EACH CASE WHETHER NOW EXISTING OR HEREAFTER ARISING, AND WHETHER FOUNDED IN
CONTRACT OR TORT OR OTHERWISE; AND EACH PARTY HEREBY AGREES AND CONSENTS THAT ANY SUCH CLAIM, DEMAND, ACTION OR CAUSE OF ACTION SHALL BE DECIDED BY COURT TRIAL WITHOUT A JURY, AND THAT ANY PARTY TO THIS AMENDMENT MAY FILE AN ORIGINAL COUNTERPART OR
A COPY OF THIS SECTION 4.4 WITH ANY COURT AS WRITTEN EVIDENCE OF THE CONSENT OF THE SIGNATORIES HERETO TO THE WAIVER OF THEIR RIGHT TO TRIAL BY JURY. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman"><U>Section</U><U></U><U>&nbsp;4.5.</U> <U>Headings</U>. The headings of this Amendment are for purposes of reference only and shall not limit
or otherwise affect the meaning hereof. </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman"><U>Section</U><U></U><U>&nbsp;4.6.</U> <U>Effect of Amendment</U>. On and after the
Amendment No.&nbsp;1 Effective Date, each reference to the Credit Agreement in any Loan Document (including to any Exhibit or Schedule attached thereto) shall be deemed to be a reference to the Credit Agreement as amended by this Amendment. Except
as expressly set forth in this Amendment, nothing herein shall be deemed to entitle any Loan Party to a consent to, or a waiver, amendment, modification or other change of, any of the terms, conditions, obligations, covenants or agreements contained
in the Credit Agreement as in effect immediately prior to the Amendment No.1 Effective Date or any other Loan Document in similar or different circumstances. This Amendment shall constitute a &#147;Loan Document&#148; for all purposes of the Credit
Agreement and the other Loan Documents. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>[Remainder of this page intentionally left blank] </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be executed and
delivered by their respective duly authorized officers as of the date first above written. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


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


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"><B><U>BORROWER</U>:</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>MEDNAX, INC.,</B></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3">a Florida Corporation</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3">Name: Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3">Title: General Counsel and Secretary</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="24"></TD>
<TD HEIGHT="24" COLSPAN="2"></TD>
<TD HEIGHT="24" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"><B><U>GUARANTORS:</U></B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>1500 CONCORD TERRACE, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>ALASKA NEONATOLOGY ASSOCIATES, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"><B>ALEGIS REVENUE GROUP, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"><B>AMERICAN ANESTHESIOLOGY ASSOCIATES OF FLORIDA, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"><B>AMERICAN ANESTHESIOLOGY ASSOCIATES OF GEORGIA, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"><B>AMERICAN ANESTHESIOLOGY ASSOCIATES OF ILLINOIS, S.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"><B>AMERICAN ANESTHESIOLOGY ASSOCIATES OF MICHIGAN, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"><B>AMERICAN ANESTHESIOLOGY ASSOCIATES OF VIRGINIA, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"><B>AMERICAN ANESTHESIOLOGY GROUP OF TENNESSEE, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"><B>AMERICAN ANESTHESIOLOGY OF FLORIDA, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"><B>AMERICAN ANESTHESIOLOGY OF GEORGIA, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="3"><B>AMERICAN ANESTHESIOLOGY OF ILLINOIS, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3">Name: Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3">Title: General Counsel and Secretary</TD></TR>
</TABLE>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <DIV ALIGN="right">
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="40%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


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


<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"><B>AMERICAN ANESTHESIOLOGY OF MARYLAND, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF MICHIGAN, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF MINNESOTA, P.A.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF NAPLES, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF NEW JERSEY, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF NEW YORK, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF NORTH CAROLINA, PLLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF SOUTH CAROLINA, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF SYRACUSE, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF TENNESSEE, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF TEXAS, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF THE SOUTHEAST, PLLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY OF VIRGINIA, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN ANESTHESIOLOGY SERVICES OF FLORIDA, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AMERICAN RADIOLOGY, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>ANESTHESIA AND PAIN MANAGEMENT GROUP, LLC</B></TD></TR>
</TABLE></DIV> <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="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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Name: Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Title: General Counsel and Secretary</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <DIV ALIGN="right">
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="40%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


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


<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"><B>ANESTHESIOLOGY CONSULTANTS OF SOUTH CAROLINA, PLLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AUGUSTA NEONATOLOGY ASSOCIATES, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>AUSTIN ANESTHESIOLOGY GROUP, PLLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>BURLINGTON ANESTHESIA ASSOCIATES, P.A.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>CARDON HEALTHCARE NETWORK, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>CENTRAL OKLAHOMA NEONATOLOGY ASSOCIATES, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>COMMUNITY RADIOLOGY PROVIDERS, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>CRITICAL CARE AND ANESTHESIA CONSULTANTS OF NEW JERSEY, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>CRITICAL HEALTH SYSTEMS, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>DATA MANAGEMENT, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>DIVERSIFIED HEALTHCARE RESOURCES, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>DUET HEALTH, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>GEORGIA PERIOPERATIVE CONSULTANTS, L.L.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>HEALTH NETWORK MANAGEMENT, L.L.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>HORIZON ANESTHESIA, PLLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>INFINITY MANAGEMENT, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>JEFFERSON RADIOLOGY, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>KEYSTONE GROUP, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>MAGELLA MEDICAL ASSOCIATES BILLING, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>MAGELLA MEDICAL ASSOCIATES MIDWEST, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>MAGELLA MEDICAL ASSOCIATES OF GEORGIA, P.C.</B></TD></TR>
</TABLE></DIV> <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="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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Name: Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Title: General Counsel and Secretary</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <DIV ALIGN="right">
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="40%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


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


<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"><B>MAGELLA MEDICAL GROUP, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B><FONT STYLE="white-space:nowrap">MED-DATA,</FONT> INCORPORATED</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>MEDDIRECT, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>MEDNAX RADIOLOGY OF TEXAS, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>MEDNAX SERVICES, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>MOUNTAIN STATES NEONATOLOGY, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>MSI CONSULTING SERVICES, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>NEONATAL SPECIALISTS, LTD.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>NEONATOLOGY ASSOCIATES OF ATLANTA, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>NIGHTHAWK RADIOLOGY SERVICES, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>NORTHWEST NEWBORN SPECIALISTS, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRICS AND PEDIATRICS SUBSPECIALTY GROUP OF KANSAS AND MISSOURI, P.A.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF ARIZONA, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF ATLANTA, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF CALIFORNIA, A PROFESSIONAL CORPORATION</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF COASTAL CAROLINA, PLLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF COLORADO, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF NEW JERSEY, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF OKLAHOMA, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF PHOENIX, P.C.</B></TD></TR>
</TABLE></DIV> <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="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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Name: Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Title: General Counsel and Secretary</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <DIV ALIGN="right">
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="40%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


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


<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"><B>OBSTETRIX MEDICAL GROUP OF SACRAMENTO, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF TEXAS BILLING, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF THE CENTRAL COAST, PROFESSIONAL CORPORATION</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF UTAH, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OBSTETRIX MEDICAL GROUP OF WASHINGTON, INC., P.S.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>OZARK NEONATAL ASSOCIATES, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PAIN CENTERS OF CHICAGO, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PATIENT ADVOCATE TECHNOLOGY, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX CARDIOLOGY OF NEW MEXICO, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX CARDIOLOGY OF ORANGE COUNTY, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX CARDIOLOGY OF SPRINGFIELD, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX CARDIOLOGY OF WASHINGTON, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX EMERGENT AND CRITICAL CARE SERVICES, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX INTERNATIONAL, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP NEONATOLOGY AND PEDIATRIC INTENSIVE CARE SPECIALISTS OF NEW YORK, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF ARKANSAS, P.A.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF CALIFORNIA, A PROFESSIONAL CORPORATION</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF COLORADO, P.C.</B></TD></TR>
</TABLE></DIV> <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="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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Name: Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Title: General Counsel and Secretary</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <DIV ALIGN="right">
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="40%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


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


<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF FLORIDA, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF GEORGIA, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF ILLINOIS, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF INDIANA, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF KANSAS, P.A.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF KENTUCKY, P.S.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF LOUISIANA, L.L.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF MICHIGAN, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF MISSISSIPPI, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF MISSOURI, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF MONTANA, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF NEW MEXICO, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF NORTH CAROLINA, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF OHIO CORP.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF OKLAHOMA, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF PENNSYLVANIA, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF SOUTH CAROLINA, P.A.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF TENNESSEE, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><B>PEDIATRIX MEDICAL GROUP OF TEXAS BILLING, INC.</B></TD></TR>
</TABLE></DIV> <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="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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Name: Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Title: General Counsel and Secretary</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="99%"></TD></TR>


<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PEDIATRIX MEDICAL GROUP OF THE <FONT STYLE="white-space:nowrap">MID-ATLANTIC,</FONT> P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PEDIATRIX MEDICAL GROUP OF WASHINGTON, INC., P.S.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PEDIATRIX MEDICAL GROUP, INC. (FL)</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PEDIATRIX MEDICAL GROUP, INC. (UT)</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PEDIATRIX MEDICAL GROUP, P.A.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PEDIATRIX MEDICAL GROUP, P.C. (VA)</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PEDIATRIX MEDICAL GROUP, P.C. (WV)</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PEDIATRIX MEDICAL SERVICES, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PEDIATRIX NEWBORN HEARING SCREEN, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PEDIATRIX OF MARYLAND, P.A.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PICKERT MEDICAL GROUP, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PIEDMONT ANESTHESIA ASSOCIATES, L.L.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PMG CARDIOLOGY, INC.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>PMGSC, P.A.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>POKROY MEDICAL GROUP OF NEVADA, LTD.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>QUANTUM CLINICAL NAVIGATION SYSTEM, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>RADIOLOGY ALLIANCE, P.C.</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>RADIOLOGY ASSOCIATES OF SOUTH FLORIDA, LLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>SOUTHEAST ANESTHESIOLOGY CONSULTANTS, PLLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>SOUTHEAST ANESTHESIOLOGY CONSULTANTS OF VIRGINIA, PLLC</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>SPECIALTY MRI, LLC</B></TD></TR></TABLE></DIV> <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="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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Name: Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Title: General Counsel and Secretary</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <DIV ALIGN="right">
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="40%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


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


<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>SUMMIT ANESTHESIA ASSOCIATES, P.A.</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>SYNERGY RADIOLOGY ASSOCIATES, PLLC</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>SYNTHESIS HEALTHCARE MANAGEMENT, LLC</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>TEXAS NEWBORN SERVICES, INC.</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>THE SURGICAL GROUP OF MIAMI, LLC</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>VIRTUAL RADIOLOGIC CORPORATION</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>VIRTUAL RADIOLOGIC PROFESSIONALS, LLC</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>VIRTUAL RADIOLOGIC PROFESSIONALS OF CALIFORNIA, P.A</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>VIRTUAL RADIOLOGIC PROFESSIONALS OF ILLINOIS, S.C.</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>VIRTUAL RADIOLOGIC PROFESSIONALS OF MICHIGAN, P.C.</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>VIRTUAL RADIOLOGIC PROFESSIONALS OF MINNESOTA, P.A.</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>VIRTUAL RADIOLOGIC PROFESSIONALS OF NEW JERSEY, P.A.</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>VIRTUAL RADIOLOGIC PROFESSIONALS OF NEW YORK, P.A.</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>VIRTUAL RADIOLOGIC PROFESSIONALS OF TEXAS, P.A.</B></P></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:2.00em; font-size:10pt; font-family:Times New Roman"><B>WESTCHESTER ANESTHESIOLOGISTS, P.C.</B></P></TD></TR>
</TABLE></DIV> <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="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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Name: Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Title: General Counsel and Secretary</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">JPMORGAN CHASE BANK, N.A.,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender, an Issuing Lender and as Administrative Agent</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ John Kushnerick</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">Name: John Kushnerick</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">Title: Executive Director</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">Bank of America, N.A.,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Joseph L. Corah</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">Name: Joseph L. Corah</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">Title: Director</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">FIFTH THIRD BANK,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Tamara Dowd</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">Name: Tamara Dowd</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">Title: Director</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">MUFG BANK, LTD. (f.k.a. THE BANK OF TOKYO-MISUBISHI UFJ, LTD.),</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Jack Lonker</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">Name: Jack Lonker</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">Title: Director</TD></TR>
</TABLE></DIV> <P STYLE="font-size:18pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">SUNTRUST BANK,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Jonathan Hart</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">Name: Jonathan Hart</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">Title: Vice President</TD></TR>
</TABLE></DIV> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P> <P STYLE="font-size:6pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">WELLS FARGO BANK, NATIONAL ASSOCIATION,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Jordan Harris</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">Name: Jordan Harris</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">Title: Director</TD></TR>
</TABLE></DIV> <P STYLE="font-size:18pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">Citizens Bank, N. A.,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Mark Guyeski</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">Name: Mark Guyeski</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">Title: Vice President</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">COMPASS BANK,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Heather Allen</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">Name: Heather Allen</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">Title: Senior Vice President</TD></TR>
</TABLE></DIV> <P STYLE="font-size:6pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">PNC BANK, NATIONAL ASSOCIATION,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Brian Miller</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">Name: Brian Miller</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">Title: Senior Vice President</TD></TR>
</TABLE></DIV> <P STYLE="font-size:18pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">REGIONS BANK,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Ned Spitzer</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">Name: Ned Spitzer</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">Title: Managing Director</TD></TR>
</TABLE></DIV> <P STYLE="font-size:18pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">BRANCH BANKING AND TRUST COMPANY,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Stephen R. Garrett</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">Name: Stephen R. Garrett</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">Title: Assistant Vice President</TD></TR>
</TABLE></DIV> <P STYLE="font-size:6pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">HSBC BANK USA, N. A.,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Peter Hart</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">Name: Peter Hart</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">Title: SVP</TD></TR>
</TABLE></DIV>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <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" COLSPAN="3">SYNOVUS BANK,</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">as a Lender</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" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Alex Falgiano</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">Name: Alex Falgiano</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">Title: Senior Portfolio Manager</TD></TR>
</TABLE></DIV> <P STYLE="font-size:18pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P>
</DIV></Center>


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


<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 A </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">[attached] </P>
</DIV></Center>


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


<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><U STYLE="border-bottom:1pt double; padding-bottom:1pt">EXHIBIT A TO AMENDMENT NO. 1</U>
</B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P> <P STYLE="line-height:1.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1px solid #000000">&nbsp;</P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">$2,000,000,000 </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">CREDIT AGREEMENT
</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">Dated as of October&nbsp;30, 2017<STRIKE>,</STRIKE> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">As amended November&nbsp;21, 2018</U> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">among </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">MEDNAX, INC., </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">as Borrower, </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">CERTAIN DOMESTIC
SUBSIDIARIES OF THE BORROWER </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">FROM TIME TO TIME PARTY HERETO, </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">as Guarantors, </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">THE LENDERS PARTY
HERETO, </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">JPMORGAN CHASE BANK, N.A., </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">as Administrative Agent, </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">BANK OF
AMERICA, N.A., </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:12pt; font-family:Times New Roman" ALIGN="center">FIFTH THIRD BANK, </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">MIZUHO BANK, LTD., </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">SUNTRUST BANK,
</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">THE BANK OF TOKYO-MITSUBISHI UFJ, LTD., </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">and </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">WELLS FARGO BANK, NATIONAL
ASSOCIATION </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">as Syndication Agents, </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">BBVA COMPASS, </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">CITIZENS BANK,
N.A., </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">PNC BANK, </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">REGIONS BANK,
</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">and </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">U.S. BANK NATIONAL
ASSOCIATION, </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">as Senior Documentation Agents, </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">BB&amp;T, </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">as Documentation Agent
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">and </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">JPMORGAN CHASE BANK, N.A., </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">FIFTH THIRD BANK </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">MERRILL LYNCH, PIERCE, FENNER&nbsp;&amp; SMITH
INCORPORATED, </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">MIZUHO BANK, LTD. </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">SUNTRUST ROBINSON HUMPHREY,
INC., </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">THE BANK OF TOKYO-MITSUBISHI UFJ, LTD., </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">and </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">WELLS FARGO SECURITIES, LLC, </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">as Joint Lead Arrangers and Joint
Bookrunners </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P> <P STYLE="line-height:1.0pt;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">


<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"><U>TABLE OF CONTENTS </U></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="right"><U>Page </U></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">ARTICLE I </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">DEFINITIONS </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;padding-bottom:2pt; margin-bottom:-1pt; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="9%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="86%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD></TD>
<TD></TD>
<TD></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Section&nbsp;1.1</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Defined Terms</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></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">Section&nbsp;1.2</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Other Definitional Provisions</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">28</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Section&nbsp;1.3</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Accounting Terms</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>28</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">29</U></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">Section&nbsp;1.4</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Time References</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Section&nbsp;1.5</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Execution of Documents</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">Section&nbsp;1.6</U></P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">Letter of Credit Amounts</U></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">Section&nbsp;1.7</U></P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">LIBOR Notification</U></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">29</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="bottom" ALIGN="center">ARTICLE II</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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">THE LOANS; AMOUNT AND TERMS</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Section&nbsp;2.1</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Revolving Loans</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>29</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">30</U></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">Section&nbsp;2.2</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">[Reserved]</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>31</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">32</U></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">Section&nbsp;2.3</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Letter of Credit Subfacility</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>31</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">32</U></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">Section&nbsp;2.4</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">[Reserved]</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>34</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">35</U></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">Section&nbsp;2.5</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Fees</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>34</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">35</U></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">Section&nbsp;2.6</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Revolving Commitment Reductions</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>34</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">35</U></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">Section&nbsp;2.7</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Repayments</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>35</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">36</U></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">Section&nbsp;2.8</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Default Rate and Payment Dates</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>35</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">36</U></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">Section&nbsp;2.9</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Conversion Options</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>36</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">37</U></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">Section&nbsp;2.10</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Computation of Interest and Fees; Usury</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>36</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">37</U></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">Section&nbsp;2.11</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Pro Rata Treatment and Payments</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>37</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">38</U></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">Section&nbsp;2.12</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Non-Receipt of Funds by the Administrative Agent</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>38</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">39</U></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">Section&nbsp;2.13</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Alternate Rate of Interest</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>39</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">40</U></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">Section&nbsp;2.14</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Yield Protection</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>40</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">41</U></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">Section&nbsp;2.15</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Indemnity</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>41</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">42</U></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">Section&nbsp;2.16</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Taxes</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>42</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">43</U></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">Section&nbsp;2.17</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Indemnification; Nature of Issuing Lenders&#146; Duties</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>44</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">45</U></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">Section&nbsp;2.18</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Illegality</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>45</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">46</U></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">Section&nbsp;2.19</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Replacement of Lenders</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>45</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">46</U></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">Section&nbsp;2.20</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Cash Collateral</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>46</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">47</U></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">Section&nbsp;2.21</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Defaulting Lenders</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>47</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">48</U></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">Section&nbsp;2.22</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Incremental Facilities</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>49</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">50</U></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="bottom" ALIGN="center">ARTICLE III</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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">REPRESENTATIONS AND WARRANTIES</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Section&nbsp;3.1</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Financial Condition</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>50</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">51</U></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">Section&nbsp;3.2</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">No Material Adverse Effect</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>51</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">52</U></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">Section&nbsp;3.3</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Corporate Existence; Compliance with Law</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>51</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">52</U></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">Section&nbsp;3.4</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Corporate Power; Authorization; Enforceable Obligations</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>51</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">52</U></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">Section&nbsp;3.5</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">No Legal Bar; No Default</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>52</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">53</U></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">Section&nbsp;3.6</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">No Material Litigation</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>52</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">53</U></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">Section&nbsp;3.7</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Investment Company Act; etc.</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>52</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">53</U></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">Section&nbsp;3.8</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Margin Regulations</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>52</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">53</U></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">Section&nbsp;3.9</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">ERISA</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>52</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">53</U></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">-i- </P>

</DIV></Center>


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


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

<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE;padding-bottom:2pt; margin-bottom:-1pt; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="9%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="86%"></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">Page</TD>
<TD 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">Section&nbsp;3.10</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Environmental Matters</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>53</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">54</U></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">Section 3.11</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Use of Proceeds</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>54</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">55</U></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">Section 3.12</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Subsidiaries; Joint Ventures; Partnerships</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>54</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">55</U></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">Section 3.13</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Ownership</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>54</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">55</U></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">Section 3.14</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Taxes</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>54</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">55</U></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">Section 3.15</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Solvency</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>55</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">56</U></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">Section 3.16</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">No Burdensome Restrictions</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>55</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">56</U></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">Section 3.17</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Brokers&#146; Fees</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>55</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">56</U></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">Section 3.18</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Labor Matters</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>55</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">56</U></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">Section 3.19</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Accuracy and Completeness of Information</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>55</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">56</U></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">Section 3.20</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Material Contracts</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>55</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">56</U></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">Section 3.21</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Insurance</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>56</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">57</U></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">Section 3.22</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Intellectual Property Matters</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>56</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">57</U></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">Section 3.23</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Classification of Senior Indebtedness</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>56</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">57</U></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">Section 3.24</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Anti-Corruption Laws and Sanctions</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>56</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">57</U></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">Section 3.25</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Consent; Governmental Authorizations</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>56</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">57</U></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">Section 3.26</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Healthcare Representations and Warranties</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>57</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">58</U></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">Section 3.27</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Security Interests</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>58</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">59</U></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"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">Section 3.28</U></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">EEA Financial Institutions</U></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">59</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"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">Section 3.29</U></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">ERISA</U></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">59</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="bottom" ALIGN="center">ARTICLE IV</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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">CONDITIONS PRECEDENT</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">Section 4.1</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Conditions to Closing Date and Initial Revolving Loans</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>58</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">59</U></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">Section 4.2</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Conditions to All Extensions of Credit</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>61</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">62</U></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="bottom" ALIGN="center">ARTICLE V</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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">AFFIRMATIVE COVENANTS</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">Section 5.1</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Financial Statements</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>62</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">63</U></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">Section 5.2</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Certificates; Other Information</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>63</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">64</U></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">Section 5.3</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Payment of Taxes and Other Obligations</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>64</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">65</U></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">Section 5.4</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Conduct of Business and Maintenance of Existence</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>64</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">65</U></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">Section 5.5</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Maintenance of Property; Insurance</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>65</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">66</U></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">Section 5.6</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Books and Records</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>65</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">66</U></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">Section 5.7</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Notices</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>65</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">66</U></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">Section 5.8</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Environmental Laws</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>66</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">67</U></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">Section 5.9</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Financial Covenants</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>67</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">68</U></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">Section 5.10</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Additional Guarantors</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>68</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">69</U></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">Section 5.11</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Compliance with Law</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>68</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">69</U></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">Section 5.12</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Further Assurances</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>68</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">69</U></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">Section 5.13</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Collateral Matters</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>69</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">70</U></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="bottom" ALIGN="center">ARTICLE VI</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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">NEGATIVE COVENANTS</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">Section 6.1</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Indebtedness</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>70</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">71</U></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">Section 6.2</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Liens</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>71</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">72</U></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">Section 6.3</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Nature of Business</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>71</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">72</U></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">Section 6.4</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Consolidation, Merger, Sale or Purchase of Assets, etc.</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>71</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">72</U></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">Section 6.5</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Investments and Acquisitions</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>73</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">74</U></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">-ii- </P>

</DIV></Center>


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


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

<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE;padding-bottom:2pt; margin-bottom:-1pt; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="9%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="86%"></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">Section 6.6</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Transactions with Affiliates</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>73</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">74</U></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">Section 6.7</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Ownership of Subsidiaries; Restrictions</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>73</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">74</U></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">Section 6.8</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Corporate Changes; Material Contracts</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>73</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">74</U></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">Section 6.9</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Limitation on Restricted Actions</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>74</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">75</U></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">Section 6.10</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Restricted Payments</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>74</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">75</U></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">Section 6.11</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Amendment of Subordinated Debt</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>75</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">76</U></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">Section 6.12</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">No Further Negative Pledges</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>75</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">76</U></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">Section 6.13</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Restrictions Regarding PMG</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>75</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">76</U></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">Section 6.14</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Use of Proceeds and Letters of Credit</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>75</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">76</U></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="bottom" ALIGN="center">ARTICLE VII</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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">EVENTS OF DEFAULT</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">Section 7.1</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Events of Default</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>75</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">76</U></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">Section 7.2</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Acceleration; Remedies</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>78</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">79</U></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="bottom" ALIGN="center">ARTICLE VIII</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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">THE ADMINISTRATIVE AGENT</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">Section 8.1</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Appointment and Authority</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>79</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">80</U></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">Section 8.2</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Nature of Duties</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>79</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">80</U></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">Section 8.3</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Exculpatory Provisions</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>79</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">80</U></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">Section 8.4</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Reliance by Administrative Agent</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>80</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">81</U></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">Section 8.5</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Notice of Default</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>80</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">81</U></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">Section 8.6</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Non-Reliance on Administrative Agent and Other Lenders</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>81</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">82</U></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">Section 8.7</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Indemnification</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>81</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">82</U></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">Section 8.8</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Administrative Agent in Its Individual Capacity</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>81</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">82</U></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">Section 8.9</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Successor Administrative Agent</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>82</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">83</U></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">Section 8.10</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Guaranty Matters</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>83</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">84</U></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">Section 8.11</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Bank Products</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>83</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">84</U></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">Section 8.12</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Withholding Tax</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>83</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">84</U></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="bottom" ALIGN="center">ARTICLE IX</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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">MISCELLANEOUS</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">Section 9.1</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Amendments and Waivers</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>83</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">84</U></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">Section 9.2</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Notices</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>86</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">87</U></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">Section 9.3</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">No Waiver; Cumulative Remedies</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>87</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">88</U></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">Section 9.4</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Survival of Representations and Warranties</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>87</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">88</U></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">Section 9.5</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Payment of Expenses; Indemnity</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>87</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">88</U></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">Section 9.6</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Successors and Assigns; Participations</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>89</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">90</U></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">Section 9.7</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Right of Setoff; Sharing of Payments</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>92</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">93</U></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">Section 9.8</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Table of Contents and Section Headings</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>93</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">94</U></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">Section 9.9</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Counterparts; Integration; Effectiveness; Electronic Execution</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>93</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">94</U></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">Section 9.10</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Severability</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>93</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">94</U></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">Section 9.11</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Integration</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>93</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">94</U></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">Section 9.12</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Governing Law</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>93</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">94</U></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">Section 9.13</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Consent to Jurisdiction; Service of Process and Venue</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>94</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">95</U></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">Section 9.14</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Confidentiality</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>94</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">95</U></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">Section 9.15</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Acknowledgments</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>95</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">96</U></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">Section 9.16</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Waivers of Jury Trial</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>95</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">96</U></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">Section&nbsp;9.17</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Patriot Act Notice</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>95</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">96</U></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">-iii- </P>

</DIV></Center>


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


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

<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE;padding-bottom:2pt; margin-bottom:-1pt; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="12%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="81%"></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></B>Page<B></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">Section 9.18</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Resolution of Drafting Ambiguities</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>96</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">97</U></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">Section 9.19</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Continuing Agreement</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>96</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">97</U></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">Section 9.20</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Lender Consent</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>96</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">97</U></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">Section 9.21</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Press Releases and Related Matters</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>96</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">97</U></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">Section 9.22</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Appointment of Borrower</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>96</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">97</U></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">Section 9.23</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Certain Waivers, Subordinations and Consents</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>97</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">98</U></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">Section 9.24</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">No Advisory or Fiduciary Responsibility</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>97</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">98</U></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">Section 9.25</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">[Reserved]</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>98</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">99</U></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">Section 9.26</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Release of Liens and Guarantees</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>98</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">99</U></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">Section 9.28</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Certain ERISA Matters</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>99</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">100</U></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="bottom" ALIGN="center">ARTICLE X</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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">GUARANTY</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">Section 10.1</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">The Guaranty</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>100</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">102</U></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">Section 10.2</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Bankruptcy</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>101</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">102</U></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">Section 10.3</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Nature of Liability</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>101</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">102</U></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">Section 10.4</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Independent Obligation</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>101</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">103</U></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">Section 10.5</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Authorization</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>102</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">103</U></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">Section&nbsp;10.6</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Reliance</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>102</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">103</U></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">Section 10.7</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Waiver</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>102</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">103</U></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">Section 10.8</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Limitation on Enforcement</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>103</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">104</U></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">Section 10.9</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Confirmation of Payment</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>103</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">104</U></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">Section 10.10</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Agreements for Contribution</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>103</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">104</U></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">Section 10.11</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Keepwell</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><STRIKE></STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt"></U>&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right"><STRIKE>104</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">105</U></TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"><B><U>Schedules</U></B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">Schedule 1.1(a)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Investments</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">Schedule 1.1(b)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Liens</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">Schedule 1.1(c)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Existing Letters of Credit</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">Schedule 2.1(a)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Commitment Percentages</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">Schedule 3.12</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Subsidiaries</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">Schedule 3.18</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Labor Matters</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">Schedule 3.21</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Insurance</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">Schedule&nbsp;5.12(e)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Post-Closing Deliveries</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">Schedule 6.1(b)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Indebtedness</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom"></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="88%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"><B><U>Exhibits</U></B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></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>Exhibit&nbsp;1.1(a)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Account Designation Notice</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;1.1(b)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Assignment and Assumption</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;1.1(c)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Joinder Agreement</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;1.1(d)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Notice of Borrowing</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;1.1(e)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Notice of Conversion/Extension</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;1.1(f)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Permitted Acquisition Certificate</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;2.1(a)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Funding Indemnity Letter</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;2.1(e)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Revolving Note</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;2.16(f)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Forms of United States Tax Compliance Certificate</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;4.1(a)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Lender Consent</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;4.1(b)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Officer&#146;s Certificate</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;4.1(e)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Solvency Certificate</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;4.1(n)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Financial Condition Certificate</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">-iv- </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="right"><U>Page </U></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:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;4.1(o)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Patriot Act Certificate</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" NOWRAP>Exhibit&nbsp;5.2(b)</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Form of Officer&#146;s Compliance Certificate</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">-v- </P>

</DIV></Center>


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


<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"><B>THIS CREDIT AGREEMENT</B>, dated as of October&nbsp;30, 2017, is by and among <B>MEDNAX,
INC.</B>, a Florida corporation (the &#147;<U>Borrower</U>&#148;), the Guarantors (as hereinafter defined), the Lenders (as hereinafter defined) and <B>JPMORGAN CHASE BANK, N.A.</B>, as administrative agent for the Lenders hereunder (in such
capacity, the &#147;<U>Administrative Agent</U>&#148;). </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE I </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>DEFINITIONS </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;1.1</B> <B><U>Defined Terms</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As used in this Agreement, terms defined in the preamble to this Agreement have the meanings therein indicated, and the following terms have
the following meanings: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Account Designation Notice</U>&#148; shall mean the Account Designation Notice dated as of the Closing
Date from the Borrower to the Administrative Agent in substantially the form attached hereto as <U>Exhibit 1.1(a)</U>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Additional Credit Party</U>&#148; shall mean each Person that becomes a Guarantor by execution of a Joinder Agreement in accordance
with Section&nbsp;5.10. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Administrative Agent</U>&#148; or &#147;<U>Agent</U>&#148; shall have the meaning set forth in the first
paragraph of this Agreement and shall include any successors in such capacity. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Administrative Questionnaire</U>&#148; shall mean
an Administrative Questionnaire in a form supplied by the Administrative Agent. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Affiliate</U>&#148; shall mean, with respect to
a specified Person, another Person that directly, or indirectly through one or more intermediaries, Controls or is Controlled by, or is under common Control with, the Person specified. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Agent Parties</U>&#148; shall have the meaning set forth in Section&nbsp;9.2(d)(ii). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Agreement</U>&#148; or &#147;<U>Credit Agreement</U>&#148; shall mean this Agreement, as amended, modified, extended, restated,
replaced, or supplemented from time to time in accordance with its terms. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Alternate Base Rate</U>&#148; shall mean, for any day,
a rate per annum equal to the greatest of (a)&nbsp;the Prime Rate in effect on such day, (b)&nbsp;the Federal Funds Effective Rate in effect on such day <U>plus</U> 1/2 of 1% and (c)&nbsp;the sum of (i)&nbsp;LIBOR (as determined pursuant to the
definition of LIBOR), for an Interest Period of one (1)&nbsp;month commencing on such day <U>plus</U> (ii) 1.00%, in each instance as of such date of determination. If for any reason the Administrative Agent shall have determined (which
determination shall be conclusive in the absence of manifest error) that it is unable to ascertain the Federal Funds Effective Rate, for any reason, including the inability or failure of the Administrative Agent to obtain sufficient quotations in
accordance with the terms set forth in the definition of Federal Funds Effective Rate, the Alternate Base Rate shall be determined without regard to clause (b)&nbsp;of the first sentence of this definition, as appropriate, until the circumstances
giving rise to such inability no longer exist. Any change in the Alternate Base Rate due to a change in any of the foregoing will become effective on the date of such change in the Federal Funds Rate, the Prime Rate or LIBOR for an Interest Period
of one (1)&nbsp;month. Notwithstanding anything contained herein to the contrary, to the extent that the provisions of Section&nbsp;2.13 shall be in effect in determining LIBOR pursuant to clause (c)&nbsp;hereof, the Alternate Base Rate shall be the
greater of (i)&nbsp;the Prime Rate in effect on such day and (ii)&nbsp;the Federal Funds Effective Rate in effect on such day <U>plus</U> 1/2 of 1%. For the avoidance of doubt, if the Alternate Base Rate shall be less than zero, such rate shall be
deemed to be zero for purposes of this Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Alternate Base Rate Loans</U>&#148; shall mean Loans that bear interest at an
interest rate based on the Alternate Base Rate. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">&#147;Amendment No.&nbsp;1&#148;
means Amendment No.&nbsp;1 to this Agreement dated as of November&nbsp;21, 2018.</U> </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">1 </P>

</DIV></Center>


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


<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"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">&#147;Amendment Lead Arranger&#148;
shall have the meaning set forth in Amendment No.&nbsp;1.</U> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">&#147;Amendment
No.&nbsp;1 Effective Date&#148; means November&nbsp;21, 2018.</U> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Anti-Corruption Laws</U>&#148; means all laws, rules, and
regulations of any jurisdiction applicable to the Borrower or its Subsidiaries from time to time concerning or relating to bribery or corruption. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Applicable Margin</U>&#148; shall mean, for any day, with respect to Revolving Loans and Unused Commitment Fees, the rate per annum
set forth below opposite the applicable level then in effect (based on the Consolidated Net Leverage Ratio), it being understood that the Applicable Margin for (a)&nbsp;Revolving Loans that are Alternate Base Rate Loans shall be the percentage set
forth under the column &#147;Alternate Base Rate Margin,&#148; (b)&nbsp;Revolving Loans that are LIBOR Rate Loans shall be the percentage set forth under the column &#147;LIBOR Margin&nbsp;&amp; L/C Fee,&#148; (c)&nbsp;the Letter of Credit Fee shall
be the percentage set forth under the column &#147;LIBOR Margin&nbsp;&amp; L/C Fee,&#148; and (d)&nbsp;the Unused Commitment Fee shall be the percentage set forth under the column &#147;Unused Commitment Fee&#148;: </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="3%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD WIDTH="27%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD WIDTH="26%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="7%"></TD>
<TD></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom" COLSPAN="11" ALIGN="center"><B>Applicable Margin</B></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>Level</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" STYLE="border-bottom:1.00pt solid #000000"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman">Consolidated Net</P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:8pt; font-family:Times New Roman">Leverage Ratio</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000">LIBOR&nbsp;Margin<BR>&amp; L/C Fee</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000">Alternate&nbsp;Base&nbsp;Rate<BR>Margin</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000">Unused<BR>Commitment&nbsp;Fee</TD></TR>


<TR BGCOLOR="#cceeff" 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; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>I</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&gt; 3.50 to 1.0</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">1.750%</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">0.750%</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">0.300%</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; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>II</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><FONT STYLE="FONT-FAMILY:SYMBOL">&#163;</FONT> 3.50 to 1.0</P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">and</P> <P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">&gt; 2.75 to 1.0</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">1.500%</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">0.500%</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">0.250%</TD></TR>
<TR BGCOLOR="#cceeff" 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; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>III</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><FONT STYLE="FONT-FAMILY:SYMBOL">&#163;</FONT> 2.75 to 1.0</P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">and</P> <P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">&gt; 2.00 to 1.0</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">1.375%</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">0.375%</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">0.200%</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; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>IV</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><FONT STYLE="FONT-FAMILY:SYMBOL">&#163;</FONT> 2.00 to 1.0</P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">and</P> <P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">&gt; 1.25 to 1.0</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">1.250%</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">0.250%</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">0.175%</TD></TR>
<TR BGCOLOR="#cceeff" 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; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>V</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"><FONT STYLE="FONT-FAMILY:SYMBOL">&#163;</FONT> 1.25 to 1.0</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">1.125%</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">0.125%</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">0.150%</TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Applicable Margin shall, in each case, be determined quarterly on the date five (5)&nbsp;Business Days
after the date on which the Administrative Agent has received from the Borrower the quarterly financial information (in the case of the first three fiscal quarters of the Borrower&#146;s fiscal year), the annual financial information (in the case of
the fourth fiscal quarter of the Borrower&#146;s fiscal year) and the certifications required to be delivered to the Administrative Agent and the Lenders in accordance with the provisions of Sections&nbsp;5.1(a), 5.1(b) and 5.2(b) (each an
&#147;<U>Interest Determination Date</U>&#148;). Such Applicable Margin shall be effective from such Interest Determination Date until the next such Interest Determination Date. After the Closing Date, if the Credit Parties shall fail to provide the
financial information or certifications in accordance with the provisions of Sections 5.1(a), 5.1(b) and 5.2(b), the Applicable Margin shall, on the date five (5)&nbsp;Business Days after the date by which the Credit Parties were so required to
provide such financial information or certifications to the Administrative Agent and the Lenders, be based on Level<B> </B>I<B> </B>until such time as such information or certifications or corrected information or corrected certificates are
provided, whereupon the Level shall be determined by the then current Consolidated Net Leverage Ratio. Notwithstanding the foregoing, the initial Applicable Margin shall be set at Level III until the financial information and certificates required
to be delivered pursuant to Section&nbsp;5 for the period ending December&nbsp;31, 2017 have been delivered to the Administrative Agent. In the event that any financial statement or certification delivered pursuant to Sections 5.1 or 5.2 is shown to
be inaccurate (regardless of whether this Agreement or the Commitments are in effect when such inaccuracy is discovered), and such inaccuracy, if corrected, would have led to the application of a higher Applicable Margin for any period (an
&#147;<U>Applicable Period</U>&#148;) than the Applicable Margin applied for such Applicable Period, the Borrower shall promptly (a)&nbsp;deliver to the Administrative Agent a corrected compliance certificate for such Applicable Period,
(b)&nbsp;determine the Applicable Margin for such Applicable Period based upon the corrected compliance certificate, and (c)&nbsp;promptly pay to the Administrative Agent for the benefit of </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">2 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
the Lenders the accrued additional interest and other fees owing as a result of such increased Applicable Margin for such Applicable Period, which payment shall be promptly distributed by the
Administrative Agent to the Lenders entitled thereto. It is acknowledged and agreed that nothing contained herein shall limit the rights of the Administrative Agent and the Lenders under the Credit Documents, including their rights under Sections
2.8 and 7.1. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Approved Bank</U>&#148; shall have the meaning set forth in the definition of &#147;Cash Equivalents.&#148; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Approved Fund</U>&#148; shall mean any Fund that is Controlled or managed by (a)&nbsp;a Lender, (b)&nbsp;an Affiliate of a Lender or
(c)&nbsp;an entity or an Affiliate of an entity that Controls or manages a Lender. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Arrangers</U>&#148; shall mean JPMCB, Wells
Fargo Securities, LLC, Merrill Lynch, Pierce, Fenner&nbsp;&amp; Smith Incorporated, The Bank of Tokyo-Mitsubishi UFJ, Ltd., SunTrust Robinson Humphrey, Inc., Mizuho Bank, Ltd. and Fifth Third
Bank<U STYLE="border-bottom:1pt double; padding-bottom:1pt"> and the Amendment Lead Arranger</U>. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Assignment and
Assumption</U>&#148; shall mean an assignment and assumption entered into by a Lender and an Eligible Assignee (with the consent of any party whose consent is required by Section&nbsp;9.6), and accepted by the Administrative Agent, in substantially
the form of <U>Exhibit</U><U></U><U>&nbsp;1.1(b)</U> or any other form <U STYLE="border-bottom:1pt double; padding-bottom:1pt">(including electronic records generated by the use of an electronic platform)</U> approved by the Administrative Agent.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U><FONT STYLE="white-space:nowrap">Bail-In</FONT> Action</U>&#148; means the exercise of any Write-Down and Conversion Powers by
the applicable EEA Resolution Authority in respect of any liability of an EEA Financial Institution. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U><FONT
STYLE="white-space:nowrap">Bail-In</FONT> Legislation</U>&#148; means, with respect to any EEA Member Country implementing Article 55 of Directive 2014/59/EU of the European Parliament and of the Council of the European Union, the implementing law
for such EEA Member Country from time to time which is described in the EU <FONT STYLE="white-space:nowrap">Bail-In</FONT> Legislation Schedule. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Bank Product</U>&#148; shall mean any of the following products, services or facilities extended to any Credit Party or any
Subsidiary by any Bank Product Provider: (a)&nbsp;Cash Management Services; (b)&nbsp;products under any Hedging Agreement (other than obligations with respect to any such Credit Party&#146;s Hedging Agreements that constitute Excluded Swap
Obligations solely with respect to such Credit Party); and (c)&nbsp;commercial credit card, purchase card and merchant card services. Any Bank Product established from and after the time that the Lenders have received written notice from the
Borrower or the Administrative Agent that an Event of Default exists, until such Event of Default has been waived in accordance with Section&nbsp;9.1, shall not be included as &#147;Credit Party Obligations&#148; for purposes of a distribution under
Section&nbsp;2.11(b). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Bank Product Debt</U>&#148; shall mean the Indebtedness and other obligations of any Credit Party or
Subsidiary relating to Bank Products. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Bank Product Provider</U>&#148; shall mean any Person that provides Bank Products to a
Credit Party or any Subsidiary to the extent that (a)&nbsp;such Person is a Lender, an Affiliate of a Lender or any other Person that was a Lender (or an Affiliate of a Lender) at the time it entered into the Bank Product but has ceased to be a
Lender (or whose Affiliate has ceased to be a Lender) under the Credit Agreement or (b)&nbsp;such Person is a Lender or an Affiliate of a Lender on the Closing Date and the Bank Product was entered into on or prior to the Closing Date (even if such
Person ceases to be a Lender or such Person&#146;s Affiliate ceased to be a Lender). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Bankruptcy Code</U>&#148; shall mean the
Bankruptcy Code in Title 11 of the United States Code, as amended, modified, succeeded or replaced from time to time. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Bankruptcy
Event</U>&#148; shall mean any of the events described in Section&nbsp;7.1(f). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">&#147;Beneficial Ownership Certification&#148; means a certification regarding
beneficial ownership or control as required by the Beneficial Ownership Regulation.</U> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">&#147;Beneficial Ownership Regulation&#148; means 31 C.F.R. &#167; 1010.230.</U> </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">


<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">&#147;<U>Benefit Plan</U>&#148; means any of (a)&nbsp;an &#147;employee benefit plan&#148;
(as defined in ERISA) that is subject to Title I of ERISA, (b)&nbsp;a &#147;plan&#148; as defined in Section&nbsp;4975 of the Code or (c)&nbsp;any Person whose assets include (for purposes of ERISA Section&nbsp;3(42) or otherwise for purposes of
Title I of ERISA or Section&nbsp;4975 of the Code) the assets of any such &#147;employee benefit plan&#148; or &#147;plan&#148;. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Borrower</U>&#148; shall have the meaning set forth in the first paragraph of this Agreement. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Borrowing Date</U>&#148; shall mean, in respect of any Loan, the date such Loan is made. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Business</U>&#148; shall have the meaning set forth in Section&nbsp;3.10. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Business Day</U>&#148; shall mean any day other than a Saturday, Sunday or other day on which commercial banks in New York, New York
are authorized or required by law to close; <U>provided</U>, <U>however</U>, that when used in connection with a rate determination, borrowing or payment in respect of a LIBOR Rate Loan, the term &#147;Business Day&#148; shall also exclude any day
on which banks in London, England are not open for dealings in Dollar deposits in the London interbank market. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Capital
Lease</U>&#148; shall mean any lease of property, real or personal, the obligations with respect to which are required to be capitalized on a balance sheet of the lessee in accordance with GAAP; <U>provided</U> that for purposes of calculating
Indebtedness hereunder, and notwithstanding Section&nbsp;1.3 hereof, the term &#147;<U>Capital Lease</U>&#148; shall not include any Capital Lease that was classified as an Operating Lease on the Closing Date or would have been classified as an
Operating Lease had such agreement been in effect on the Closing Date prior to a relevant change in law or change in GAAP (from GAAP as in effect on the Closing Date) which has the effect of <FONT STYLE="white-space:nowrap">re-classifying</FONT>
such agreement as a Capital Lease. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Capital Lease Obligations</U>&#148; shall mean the capitalized lease obligations, determined
in accordance with GAAP, relating to a Capital Lease. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Cash Collateralize</U>&#148; shall mean to pledge and deposit with or
deliver to the Administrative Agent, for the benefit of the Issuing Lenders (as applicable) and the Lenders, as collateral for LOC Obligations or obligations of Lenders to fund participations in respect thereof (as the context may require), cash or
deposit account balances or, if the applicable Issuing Lender benefiting from such collateral shall agree in its sole discretion, other credit support, in each case pursuant to documentation in form and substance reasonably satisfactory to
(a)&nbsp;the Administrative Agent and (b)&nbsp;such Issuing Lender. &#147;Cash Collateral&#148; shall have a meaning correlative to the foregoing and shall include the proceeds of such cash collateral and other credit support. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Cash Equivalents</U>&#148; shall mean (a)&nbsp;securities issued or directly and fully guaranteed or insured by the United States of
America or any agency or instrumentality thereof (<U>provided</U> that the full faith and credit of the United States of America is pledged in support thereof) having maturities of not more than twelve months from the date of acquisition
(&#147;<U>Government Obligations</U>&#148;), (b)&nbsp;Dollar denominated time deposits, certificates of deposit, eurodollar time deposits and eurodollar certificates of deposit of (i)&nbsp;any domestic commercial bank of recognized standing having
capital and surplus in excess of $500,000,000, (ii) any U.S. branch or agency of a <FONT STYLE="white-space:nowrap">non-U.S.</FONT> commercial bank of internationally recognized standing, having capital and surplus in excess of $500,000,000 or
(iii)&nbsp;any bank whose short-term commercial paper rating is at least <FONT STYLE="white-space:nowrap">A-2</FONT> or the equivalent thereof from S&amp;P or at least <FONT STYLE="white-space:nowrap">P-2</FONT> or the equivalent thereof from
Moody&#146;s (any such bank being an &#147;<U>Approved Bank</U>&#148;), in each case with maturities of not more than three hundred sixty-four (364)&nbsp;days from the date of acquisition, (c)&nbsp;commercial paper and variable or fixed rate notes
issued by any Approved Bank (or by the parent company thereof) or any variable rate notes issued by, or guaranteed by any domestic corporation rated <FONT STYLE="white-space:nowrap">A-2</FONT> (or the equivalent thereof) or better by S&amp;P or <FONT
STYLE="white-space:nowrap">P-2</FONT> (or the equivalent thereof) or better by Moody&#146;s and maturing within six months of the date of acquisition, (d)&nbsp;repurchase agreements with a term of not more than thirty (30)&nbsp;days with a bank or
trust company (including a Lender) or a recognized securities broker dealer having capital and surplus in excess of $500,000,000 for direct obligations issued by or fully guaranteed by the United States of America, (e)&nbsp;obligations of any state
of the United States or any political subdivision thereof for the payment of the principal and redemption price of and interest on which there shall have been irrevocably deposited Government Obligations maturing as to principal and interest at
times and in amounts sufficient to provide such payment, (f)&nbsp;money market accounts subject to Rule <FONT STYLE="white-space:nowrap">2a-7</FONT> of the Investment Company Act of 1940 (&#147;<U>Rule
<FONT STYLE="white-space:nowrap">2a-7</FONT></U>&#148;) which consist primarily of cash and cash equivalents set forth </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
in clauses (a)&nbsp;through (e) above and of which 95% shall at all times be comprised of First Tier Securities (as defined in Rule <FONT STYLE="white-space:nowrap">2a-7)</FONT> and any remaining
amount shall at all times be comprised of Second Tier Securities (as defined in Rule <FONT STYLE="white-space:nowrap">2a-7)</FONT> and (g)&nbsp;shares of any <FONT STYLE="white-space:nowrap">so-called</FONT> &#147;money market fund&#148;;
<U>provided</U> that such fund is registered under the Investment Company Act of 1940, has net assets of at least $500,000,000 and has an investment portfolio with an average maturity of three hundred sixty-five (365)&nbsp;days or less. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Cash Management Services</U>&#148; shall mean any services provided from time to time to any Credit Party or Subsidiary in connection
with operating, collections, payroll, trust, or other depository or disbursement accounts, including automatic clearinghouse, controlled disbursement, depository, electronic funds transfer, information reporting, lockbox, stop payment, overdraft
and/or wire transfer services and all other treasury and cash management services. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Change in Law</U>&#148; shall mean the
occurrence, after the date of this Agreement, of any of the following: (a)&nbsp;the adoption or taking effect of any law, rule, regulation or treaty, (b)&nbsp;any change in any law, rule, regulation or treaty or in the administration,
interpretation, implementation or application thereof by any Governmental Authority or (c)&nbsp;the making or issuance of any request, rule, guideline or directive (whether or not having the force of law) by any Governmental Authority;
<U>provided</U>, that notwithstanding anything herein to the contrary, (i)&nbsp;the Dodd-Frank Wall Street Reform and Consumer Protection Act and all requests, rules, guidelines or directives thereunder or issued in connection therewith and
(ii)&nbsp;all requests, rules, guidelines or directives promulgated by the Bank for International Settlements, the Basel Committee on Banking Supervision (or any successor or similar authority) or the United States or foreign regulatory authorities,
in each case pursuant to Basel III, shall in each case be deemed to be a &#147;Change in Law,&#148; regardless of the date enacted, adopted or issued. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Change of Control</U>&#148; shall mean at any time,<B> </B>the occurrence of any of the following events:(a)&nbsp;any
&#147;person&#148; or &#147;group&#148; (as such terms are used in Section&nbsp;13(d) and 14(d) of the Exchange Act), is or becomes the &#147;beneficial owner&#148; (as defined in Rules <FONT STYLE="white-space:nowrap">13d-3</FONT> and <FONT
STYLE="white-space:nowrap">13d-5</FONT> under the Exchange Act, except that a person shall be deemed to have &#147;beneficial ownership&#148; of all securities that such person has the right to acquire, whether such right is exercisable immediately
or only after the passage of time), directly or indirectly, of<B> </B>thirty-five percent (35%)<B> </B>or more of the then outstanding Voting Stock of the Borrower; (b)&nbsp;during any period of 12 consecutive months, a majority of the members of
the board of directors or other equivalent governing body of the Borrower shall cease to be composed of individuals (i)&nbsp;who were members of that board or equivalent governing body on the first day of such period, (ii)&nbsp;whose election or
nomination to that board or equivalent governing body was approved by individuals referred to in clause (i)&nbsp;above constituting at the time of such election or nomination at least a majority of that board or equivalent governing body or
(iii)&nbsp;whose election or nomination to that board or other equivalent governing body was approved by individuals referred to in clauses (i)&nbsp;and (ii) above constituting at the time of such election or nomination at least a majority of that
board or equivalent governing body; or (c)&nbsp;any Person or two or more Persons acting in concert shall have entered into a contract or arrangement that, upon consummation thereof, would result in the occurrence of an event that would violate
either (a)&nbsp;or (b) above. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Closing Date</U>&#148; shall mean <STRIKE>the date of this
Agreement</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">October&nbsp;30, 2017.</U> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>CMS</U>&#148; shall mean
the Centers for Medicare and Medicaid Services. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Code</U>&#148; shall mean the Internal Revenue Code of 1986, as amended from
time to time. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Collateral</U>&#148; shall mean, (a) 100% of the Equity Interests of each Guarantor, (b)&nbsp;Equity Interests in
any Foreign Subsidiary or FSHCO up to but not in excess of 65% of the voting Equity Interests and 100% of the <FONT STYLE="white-space:nowrap">non-voting</FONT> Equity Interests of such Foreign Subsidiary or FSHCO, as applicable and (c)&nbsp;all
tangible and intangible personal property of any Credit Party (including but not limited to accounts receivable, inventory, equipment, general intangibles (including contract rights), deposit and securities accounts, investment property,
intellectual property, intercompany notes, instruments, chattel paper and documents, letter of credit rights, commercial tort claims and proceeds of the foregoing), other than Excluded Assets. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Collateral Agreement</U>&#148; shall mean an agreement among each of the Credit Parties and the Administrative Agent, whereby the
perfected first-priority security interests required by the definition of &#147;Collateral Event&#148; are granted to the Administrative Agent on behalf of each of the Lenders and Bank Product Providers. </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">


<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">&#147;<U>Collateral Event</U>&#148; shall mean the date, if any, upon which each of the
following events has occurred (it being understood that the decision whether or not to cause any of the following events to occur shall be within the Borrower&#146;s sole discretion, but that no &#147;Collateral Event&#148; shall have occurred until
all of the following are completed or the completion thereof is waived by the Administrative Agent): </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) the Administrative Agent shall
have received from each Credit Party, a counterpart of the Collateral Agreement duly executed and delivered on behalf of such Credit Party, which Collateral Agreement, when taken together with the other requirements of this definition of
&#147;Collateral Event&#148; shall grant first priority security interests in favor of the Administrative Agent in all of the Collateral; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) the Administrative Agent for the benefit of the Lenders and Bank Product Providers shall have received all certificates (if any)
representing the Equity Interests pledged as Collateral, together with stock powers or other instruments of transfer with respect thereto endorsed in blank; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) all Indebtedness having, in the case of each instance of Indebtedness, an aggregate principal amount in excess of $5,000,000 (other than
to the extent that a pledge of such promissory note or instrument would violate applicable law) that is owing to any Credit Party and evidenced by a promissory note or an instrument and constitutes Collateral shall have been pledged pursuant to the
Collateral Agreement, and the Administrative Agent shall have received all such promissory notes or instruments, together with note powers or other instruments of transfer with respect thereto endorsed in blank; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) the Administrative Agent shall have received from each Credit Party, a counterpart of the Global Intercompany Note, duly executed and
delivered on behalf of such Credit Party; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) except as contemplated by any Security Document or otherwise agreed by the Administrative
Agent, all documents and instruments, including Uniform Commercial Code financing statements and filings with the United States Copyright Office and the United States Patent and Trademark Office, and all other actions required by law or reasonably
requested by the Administrative Agent to be filed, registered or recorded to create the Liens intended to be created by the Security Documents (in each case, including any supplements thereto) and perfect such Liens to the extent required by, and
with the priority required by, the Security Documents, shall have been filed, registered or recorded or delivered to the Administrative Agent for filing, registration or the recording concurrently with, or promptly following, the execution and
delivery of each such Security Document and at all times thereafter (it being understood and agreed that (A)&nbsp;control agreements shall not be required with respect to any deposit accounts, securities accounts or commodities accounts and
(B)&nbsp;no perfection actions shall be required with respect to (x)&nbsp;commercial tort claims not exceeding $5,000,000, (y) motor vehicles and other assets subject to certificates of title, and (z)&nbsp;letter of credit rights, except to the
extent constituting a support obligation for other Collateral as to which perfection is accomplished solely by the filing of a Uniform Commercial Code financing statement or equivalent); </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) the Administrative Agent shall have received insurance certificates from the Borrower&#146;s insurance broker or other evidence reasonably
satisfactory to it that all insurance required to be maintained pursuant to this Credit Agreement is in full force and effect and such certificates shall comply with the requirements set forth in this Credit Agreement; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(g) the Administrative Agent shall (i)&nbsp;have received (A)&nbsp;searches of Uniform Commercial Code filings in the jurisdiction of
incorporation or formation, as applicable, of each Credit Party and each jurisdiction where any Collateral is located or where a filing would need to be made in order to perfect the Administrative Agent&#146;s security interest in the Collateral,
copies of the financing statements on file in such jurisdictions and evidence that no Liens exist other than Permitted Liens and (B)&nbsp;tax lien and judgment searches and (ii)&nbsp;evidence of the release of Liens that are not Permitted Liens;
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(h) the Administrative Agent shall have received, for the benefit of the Lenders and Bank Product Providers, an opinion or opinions
(including, if relevant, local counsel opinions) of counsel for the Credit Parties, dated as of the date of the Collateral Event, and addressed to the Administrative Agent and the Lenders, in customary form and substance reasonably acceptable to the
Administrative Agent (which shall include opinions regarding the validity and perfection of the Liens granted in connection with the Collateral Event). </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">


<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">&#147;<U>Commitment</U>&#148; shall mean the Revolving Commitments, the LOC Commitment and
any Incremental Commitment, individually or collectively, as appropriate. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Commitment Letter</U>&#148; shall mean the commitment
letter agreement dated as of October&nbsp;23, 2017, among the Borrower, JPMCB, Wells Fargo Bank, National Association, Bank of America, N.A., SunTrust Bank, Mizuho Bank Ltd., Fifth Third Bank and the Arrangers. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Commitment Percentage</U>&#148; shall mean the Revolving Commitment Percentage and any such other &#147;Commitment Percentage&#148;
determined pursuant to Section&nbsp;2.22(d). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Commitment Period</U>&#148; shall mean (a)&nbsp;with respect to Revolving Loans the
period from and including the Closing Date to but excluding the Maturity Date and (b)&nbsp;with respect to Letters of Credit, the period from and including the Closing Date to but excluding the date that is thirty (30)&nbsp;days prior to the
Maturity Date. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Committed Funded Exposure</U>&#148; shall mean, as to any Lender at any time, the aggregate principal amount at
such time of its outstanding Loans, LOC Obligations and Participation Interests at such time. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Commonly Controlled
Entity</U>&#148; shall mean an entity, whether or not incorporated, which is under common control with the Borrower within the meaning of Section&nbsp;4001(b)(1) of ERISA or is part of a group which includes the Borrower and which is treated as a
single employer under Section&nbsp;414(b) or 414(c) of the Code or, solely for purposes of Section&nbsp;412 of the Code to the extent required by such Section, Section&nbsp;414(m) or 414(o) of the Code. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Communications</U>&#148; shall mean, collectively, any notice, demand, communication, information, document or other material
provided by or on behalf of the Borrower pursuant to any Credit Document or the transactions contemplated therein which is distributed to the Administrative Agent, any Lender or any Issuing Lender by means of electronic communications pursuant to
Section&nbsp;9.2, including through the Platform. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Consolidated</U>&#148; shall mean, when used with reference to financial
statements or financial statement items of the Borrower and its Subsidiaries or any other Person, such statements or items on a consolidated basis in accordance with the consolidation principles of GAAP. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Consolidated Assets</U>&#148; shall mean, as of any date of determination, the Consolidated assets of the Credit Parties and their
Subsidiaries at such date, as determined in accordance with GAAP. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Consolidated EBITDA</U>&#148; shall mean, as of any date of
determination for the four consecutive fiscal quarter period ending on such date, without duplication, (a)&nbsp;Consolidated Net Income for such period plus (b)&nbsp;the sum of the following to the extent deducted in calculating Consolidated Net
Income for such period: (i)&nbsp;Consolidated Interest Expense for such period, (ii)&nbsp;tax expense (including, without limitation, any federal, state, local and foreign income and similar taxes) of the Credit Parties and their Subsidiaries for
such period, (iii)&nbsp;depreciation and amortization expense of the Credit Parties and their Subsidiaries for such period, <FONT STYLE="white-space:nowrap">(iv)&nbsp;non-cash</FONT> expenses of the Borrower and its Subsidiaries related to the
equity compensation of any current or former employee or director of the Borrower or any Subsidiary or pursuant to any equity compensation plan of the Borrower <STRIKE>and,</STRIKE> (v)&nbsp;other <STRIKE>non-recurring</STRIKE> <FONT
STYLE="white-space:nowrap">non-cash</FONT> charges (excluding reserves for future cash charges) of the Credit Parties and their Subsidiaries for such period<STRIKE> and</STRIKE>, (vi)&nbsp;actual fees and expenses incurred in connection with the
transactions relating to this Agreement during the period ending on the 30th day following the Closing Date <STRIKE>minus (c)</STRIKE> <U STYLE="border-bottom:1pt double; padding-bottom:1pt">or the Amendment No.&nbsp;1 Effective Date, as applicable,
(vii)&nbsp;costs and expenses for pending or threatened <FONT STYLE="white-space:nowrap">non-ordinary</FONT> course litigation or disputes incurred during such period, (viii)&nbsp;the amount of all extraordinary, unusual or <FONT
STYLE="white-space:nowrap">non-recurring</FONT> losses, expenses or charges incurred during such period, and (ix)&nbsp;any costs, fees, charges, accruals and reserves incurred during such period in connection with any integration, transition,
facilities openings, vacant facilities, consolidations, relocations, closing, acquisitions, Permitted JV Investments and Dispositions, business optimization and entry into new markets, including technology, systems and infrastructure design, upgrade
and implementation costs, consulting fees, restructuring costs, severance and curtailments or modifications to pension or postretirement employee benefit plans, plus (c)&nbsp;the amount of net cost savings, operating expense reductions and synergies
projected by the Borrower (for the Borrower and/or its Subsidiaries) in good faith to be realized as a result of any transaction, restructuring initiative, cost savings initiative or operational change (which cost savings, operating expense
reductions or</U> </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
<U STYLE="border-bottom:1pt double; padding-bottom:1pt">synergies shall be calculated on a pro forma basis as though such cost savings, operating expense reductions or synergies had been realized
on the first day of such period), net of the amount of actual benefits realized during such period from such transaction, initiative or change; provided that (A)&nbsp;such cost savings, operating expense reductions or synergies are reasonably
identifiable and factually supportable and (B)&nbsp;such actions have been taken or are to be taken within 18 months of the consummation of such transaction or the date of commencement of such initiative or change, as applicable, minus
(d)</U>&nbsp;federal, state, local and foreign income tax credits of the Borrower and its Subsidiaries for such period minus (<STRIKE>d</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">e</U>)&nbsp;all
<FONT STYLE="white-space:nowrap">non-cash</FONT> items increasing Consolidated Net Income for such period minus (<STRIKE>e</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">f</U><FONT STYLE="white-space:nowrap">)&nbsp;non-cash</FONT>
charges previously added back to Consolidated Net Income in determining Consolidated EBITDA to the extent such <FONT STYLE="white-space:nowrap">non-cash</FONT> charges have become cash charges during such period;
<U STYLE="border-bottom:1pt double; padding-bottom:1pt">provided that the amounts included under clauses (b)(vii), (b)(viii), (b)(ix) and (c)&nbsp;above shall not exceed 20% of Consolidated EBITDA (prior to giving effect to the such clauses).</U>
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Consolidated Funded Debt</U>&#148; shall mean, as of any date of determination, Funded Debt of the Credit Parties and their
Subsidiaries<B> </B>on a Consolidated basis. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Consolidated Interest Expense</U>&#148; shall mean, as of any date of determination
for the four consecutive fiscal quarter period ending on such date, all interest expense (excluding amortization of debt discount and premium, but including the interest component under Capital Leases and synthetic leases, tax retention operating
leases, <FONT STYLE="white-space:nowrap">off-balance</FONT> sheet loans and similar <FONT STYLE="white-space:nowrap">off-balance</FONT> sheet financing products) for such period of the Credit Parties and their Subsidiaries<B> </B>on a Consolidated
basis. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Consolidated Net Leverage Ratio</U>&#148; shall mean, as of the date of the last day of any fiscal quarter of the
Borrower, for the Credit Parties and their Subsidiaries<B> </B>on a Consolidated basis, the ratio of (a)(i)&nbsp;Consolidated Funded Debt of the Credit Parties and their Subsidiaries<B> </B>on such date minus (ii)&nbsp;the aggregate amount of
unrestricted cash and Cash Equivalents of the Credit Parties and their Subsidiaries on a Consolidated basis in each case as of such date, to (b)&nbsp;Consolidated EBITDA. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Consolidated Net Income</U>&#148; shall mean, as of any date of determination for the four consecutive fiscal quarter period ending
on such date, for the Credit Parties and their Subsidiaries on a Consolidated basis, the net income of the Credit Parties and their Subsidiaries (excluding extraordinary gains, including the <FONT STYLE="white-space:nowrap">write-up</FONT> of
assets, but including extraordinary losses) for that period, <U>minus</U> the income of any Subsidiary of the Borrower (including income of a Subsidiary of such Subsidiary attributed thereto) to the extent the payment of such income in the form of a
Restricted Payment or repayment of Indebtedness to the Borrower or to another Subsidiary not so restricted is not permitted on account of any provision of any organization document, Contractual Obligation or law applicable to such Subsidiary.
Consolidated Net Income shall exclude any income or loss attributable to a Permitted JV (other than dividends or distributions received in cash or Cash Equivalents from such Permitted JV by a Credit Party or Subsidiary (other than another Permitted
JV)) to the extent the financial results of such Permitted JV are not Consolidated with the financial results of the Borrower and its Subsidiaries. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Consolidated Total Assets</U>&#148; shall mean, as of any date of determination, Consolidated Assets as set forth in the Consolidated
balance sheet of the Credit Parties and their Subsidiaries most recently delivered pursuant to S<U>ection</U><U></U><U>&nbsp;5.1(a)</U> or <U>(b)</U>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Contractual Obligation</U>&#148; shall mean, as to any Person, any obligations or liabilities of such Person arising under any
provision of any security issued by such Person or of any contract, agreement, instrument or undertaking to which such Person is a party or by which it or any of its property is bound. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Control</U>&#148; shall mean the possession, directly or indirectly, of the power to direct or cause the direction of the management
or policies of a Person, whether through the ability to exercise voting power, by contract or otherwise. &#147;<U>Controlling</U>&#148; and &#147;<U>Controlled</U>&#148; have meanings correlative thereto. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Copyright Licenses</U>&#148; shall mean any agreement, whether written or oral, providing for the grant by or to a Person of any
right under any Copyright. </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">8 </P>

</DIV></Center>


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


<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">&#147;<U>Copyrights</U>&#148; shall mean all copyrights in all Works, all registrations and
recordings thereof, and all applications in connection therewith, including, without limitation, registrations, recordings and applications in the United States Copyright Office or in any similar office or agency of the United States, any state
thereof or any other country or any political subdivision thereof, or otherwise and all renewals thereof. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Credit
Documents</U>&#148; shall mean this Agreement, <U STYLE="border-bottom:1pt double; padding-bottom:1pt">Amendment No.&nbsp;1</U>, each of the Notes, any Joinder Agreement, the Letters of Credit, the LOC Documents and the Security Documents, if any,
and all other agreements, documents, certificates and instruments delivered to the Administrative Agent or any Lender by any Credit Party in connection therewith (other than any agreement, document, certificate or instrument related to a Bank
Product). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Credit Party</U>&#148; shall mean any of the Borrower or the Guarantors. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Credit Party Obligations</U>&#148; shall mean, without duplication, (a)&nbsp;the Obligations and (b)&nbsp;for purposes of the
Guaranty, the sharing thereof and/or payments from proceeds thereof, all Bank Product Debt. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Debtor Relief Laws</U>&#148; shall
mean the Bankruptcy Code and all other liquidation, conservatorship, bankruptcy, assignment for the benefit of creditors, moratorium, rearrangement, receivership, insolvency, reorganization, or similar debtor relief Laws of the United States or
other applicable jurisdictions from time to time in effect. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Default</U>&#148; shall mean any of the events specified in
Section&nbsp;7.1, whether or not any requirement for the giving of notice or the lapse of time, or both, or any other condition, has been satisfied. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Default Rate</U>&#148; shall mean (a)&nbsp;when used with respect to the Loans, an interest rate equal to (i)&nbsp;for Alternate Base
Rate Loans (A)&nbsp;the Alternate Base Rate <U>plus</U> (B)&nbsp;the Applicable Margin, if any, applicable to Alternate Base Rate Loans <U>plus</U> (C)&nbsp;2% per annum and (ii)&nbsp;for LIBOR Rate Loans, (A)&nbsp;the LIBOR Rate <U>plus</U>
(B)&nbsp;the Applicable Margin applicable to LIBOR Rate Loans <U>plus</U> (C)&nbsp;2% per annum, (b)&nbsp;when used with respect to Letter of Credit Fees, a rate equal to the Applicable Margin <U>plus</U> 2% per annum and (c)&nbsp;when used with
respect to any other fee, overdue interest or any other Obligations or amount due hereunder, an interest rate equal to (A)&nbsp;the Alternate Base Rate <U>plus</U> (B)&nbsp;the Applicable Margin, if any, applicable to Alternate Base Rate Loans
<U>plus</U> (C)&nbsp;2% per annum. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Defaulting Lender</U>&#148; shall mean, subject to Section&nbsp;2.21(b) any Lender that,
(a)&nbsp;has failed to (i)&nbsp;fund all or any portion of its Revolving Loans, Incremental Loans, or participations in LOC Obligations required to be funded by it hereunder within two (2)&nbsp;Business Days of the date such Loans were required to
be funded hereunder unless such Lender notifies the Administrative Agent and the Borrower in writing that such failure is the result of such Lender&#146;s determination that one or more conditions precedent to funding (each of which conditions
precedent, together with any applicable default, shall be specifically identified in such writing) has not been satisfied, or (ii)&nbsp;pay to the Administrative Agent, the Issuing Lenders or any other Lender any other amount required to be paid by
it hereunder (including in respect of its participation in Letters of Credit) within two (2)&nbsp;Business Days of the date when due, (b)&nbsp;has notified the Borrower, the Administrative Agent or any Issuing Lender in writing that it does not
intend to comply with its funding obligations hereunder, or has made a public statement to that effect (unless such writing or public statement relates to such Lender&#146;s obligation to fund a Loan hereunder and states that such position is based
on such Lender&#146;s determination that a condition precedent to funding (which condition precedent, together with any applicable default, shall be specifically identified in such writing or public statement) cannot be satisfied), (c) has failed,
within three (3)&nbsp;Business Days after written request by the Administrative Agent or the Borrower, to confirm in writing to the Administrative Agent and the Borrower that it will comply with its prospective funding obligations hereunder
(provided that such Lender shall cease to be a Defaulting Lender pursuant to this clause (c)&nbsp;upon receipt of such written confirmation by the Administrative Agent and the Borrower), or (d)&nbsp;has, or has a direct or indirect parent company
that has, (i)&nbsp;become the subject of a proceeding under any Debtor Relief Law, (ii)&nbsp;had appointed for it a receiver, custodian, conservator, trustee, administrator, assignee for the benefit of creditors or similar Person charged with
reorganization or liquidation of its business or assets, including the Federal Deposit Insurance Corporation or any other state or federal regulatory authority acting in such a capacity or (iii)&nbsp;become the subject of a <FONT
STYLE="white-space:nowrap">Bail-In</FONT> Action; <U>provided</U> that a Lender shall not be a Defaulting Lender solely by virtue of the ownership or acquisition of any equity interest in that Lender or any direct or indirect parent company thereof
by a Governmental Authority so long as such ownership interest does not result in or provide such Lender with immunity from the jurisdiction of courts within the United States or from the enforcement of judgments or writs of attachment
</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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
on its assets or permit such Lender (or such Governmental Authority) to reject, repudiate, disavow or disaffirm any contracts or agreements made with such Lender. Any determination by the
Administrative Agent that a Lender is a Defaulting Lender under clauses (a)&nbsp;through (d) above shall be conclusive and binding absent manifest error, and such Lender shall be deemed to be a Defaulting Lender (subject to Section&nbsp;2.21(b))
upon delivery of written notice of such determination to the Borrower, each Issuing Lender and each Lender. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Disposition</U>&#148; shall have the meaning set forth in Section&nbsp;6.4(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">&#147;Dividing Person&#148; has the meaning assigned to it in the definition of
&#147;Division&#148;.</U> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">&#147;Division&#148; means the division of the assets,
liabilities and/or obligations of a Person (the &#147;Dividing Person&#148;) among two or more Persons (whether pursuant to a &#147;plan of division&#148; or similar arrangement), which may or may not include the Dividing Person and pursuant to
which the Dividing Person may or may not survive.</U> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">&#147;Division
Successor&#148; means any Person that, upon the consummation of a Division of a Dividing Person, holds all or any portion of the assets, liabilities and/or obligations previously held by such Dividing Person immediately prior to the consummation of
such Division. A Dividing Person which retains any of its assets, liabilities and/or obligations after a Division shall be deemed a Division Successor upon the occurrence of such Division.</U> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Dollars</U>&#148; and &#147;<U>$</U>&#148; shall mean dollars in lawful currency of the United States of America. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Domestic Lending Office</U>&#148; shall mean, initially, the office of each Lender designated as such Lender&#146;s Domestic Lending
Office shown in such Lender&#146;s Administrative Questionnaire; and thereafter, such other office of such Lender as such Lender may from time to time specify to the Administrative Agent and the Borrower as the office of such Lender at which
Alternate Base Rate Loans of such Lender are to be made. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Domestic Subsidiary</U>&#148; shall mean any Subsidiary that is
organized under the laws of the United States or any state thereof or under the laws of the District of Columbia. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>EEA Financial
Institution</U>&#148; means (a)&nbsp;any institution established in any EEA Member Country which is subject to the supervision of an EEA Resolution Authority, (b)&nbsp;any entity established in an EEA Member Country which is a parent of an
institution described in clause (a)&nbsp;of this definition, or (c)&nbsp;any institution established in an EEA Member Country which is a subsidiary of an institution described in clauses (a)&nbsp;or (b) of this definition and is subject to
consolidated supervision with its parent. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>EEA Member Country</U>&#148; means any of the member states of the European Union,
Iceland, Liechtenstein, and Norway. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>EEA Resolution Authority</U>&#148; means any public administrative authority or any Person
entrusted with public administrative authority of any EEA Member Country (including any delegee) having responsibility for the resolution of any EEA Financial Institution. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Eligible Assignee</U>&#148; shall mean (a)&nbsp;a Lender, (b)&nbsp;an Affiliate of a Lender, (c)&nbsp;an Approved Fund and
(d)&nbsp;any other Person (other than a natural person) approved by (i)&nbsp;the Administrative Agent, (ii)&nbsp;in the case of any assignment of a Revolving Commitment, the Issuing Lenders and (iii)&nbsp;unless an Event of Default under
<U>Section</U><U></U><U>&nbsp;7.1(a)</U> or <U>(f)</U>&nbsp;has occurred and is continuing and so long as the Primary<B> </B>Syndication of the Loans has been completed as determined by JPMCB, the Borrower (each such approval not to be unreasonably
withheld or delayed); <U>provided</U> that notwithstanding the foregoing, &#147;Eligible Assignee&#148; shall not include (A)&nbsp;any Credit Party or any of the Credit Party&#146;s Affiliates or Subsidiaries, (B)&nbsp;any Person holding
Subordinated Debt of the Credit Parties or (C)&nbsp;any Defaulting Lender. </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>

</DIV></Center>


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


<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">&#147;<U>Environmental Laws</U>&#148; shall mean any and all applicable foreign, federal,
state, local or municipal laws, rules, orders, regulations, statutes, ordinances, codes, decrees, requirements of any Governmental Authority or other Requirement of Law (including common law) regulating, relating to or imposing liability or
standards of conduct concerning protection of the environment, as now or may at any time be in effect during the term of this Agreement. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Equity Holder</U>&#148; shall mean any Person that owns the Equity Interests in any Practice that is a party to any Management
Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Equity Interests</U>&#148; shall mean (a)&nbsp;in the case of a corporation, capital stock, (b)&nbsp;in the case of
an association or business entity, any and all shares, interests, participations, rights or other equivalents (however designated) of capital stock, (c)&nbsp;in the case of a partnership, partnership interests (whether general, preferred or
limited), (d)&nbsp;in the case of a limited liability company, membership interests and (e)&nbsp;any other interest or participation that confers or could confer on a Person the right to receive a share of the profits and losses of, or distributions
of assets of, the issuing Person, without limitation, options, warrants and any other &#147;equity security&#148; as defined in Rule <FONT STYLE="white-space:nowrap">3a11-1</FONT> of the Exchange Act. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>ERISA</U>&#148; shall mean the Employee Retirement Income Security Act of 1974, as amended from time to time. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>EU <FONT STYLE="white-space:nowrap">Bail-in</FONT> Legislation Schedule</U>&#148; means the EU
<FONT STYLE="white-space:nowrap">Bail-In</FONT> Legislation Schedule published by the Loan Market Association (or any successor Person), as in effect from time to time. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Eurodollar Reserve Percentage</U>&#148; shall mean for any day, the percentage (expressed as a decimal and rounded upwards, if
necessary, to the next higher 1/100th of 1%) which is in effect for such day as prescribed by the Board of Governors of the Federal Reserve System (the &#147;<U>Board</U>&#148;) (or any successor) for determining the maximum reserve requirement
(including, without limitation, any basic, supplemental or emergency reserves) in respect of eurocurrency liabilities, as defined in Regulation D of the Board as in effect from time to time, or any similar category of liabilities for a member bank
of the Federal Reserve System in New York City. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Event of Default</U>&#148; shall mean any of the events specified in
Section&nbsp;7.1; <U>provided</U>, <U>however</U>, that any requirement for the giving of notice or the lapse of time, or both, or any other condition, has been satisfied. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Exchange Act</U>&#148; shall mean the Securities Exchange Act of 1934, as amended. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Excluded Assets</U>&#148; shall mean (i)&nbsp;any real property (including real property leasehold interests), (ii) any governmental
licenses or state or local franchises, charters or authorizations, to the extent a security interest in any such licenses, franchise, charter or authorization would be prohibited or restricted thereby (including any legally effective prohibition or
restriction), (iii) any assets the pledge of which, or the ownership of which by any Person other than a licensed physician, would be prohibited by applicable law, rule or regulation, (iv)&nbsp;margin stock, (v)&nbsp;any <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">intent-to-use</FONT></FONT> trademark application prior to the filing of a &#147;Statement of Use&#148; or &#147;Amendment to Allege Use&#148; with respect thereto, (vi)&nbsp;any lease,
license or other agreement or contract or any property subject to a purchase money security interest, capital lease obligation or similar arrangement to the extent that a grant of a security interest therein would violate or invalidate such lease,
license or agreement or contract or purchase money, capital lease or similar arrangement or create a right of termination in favor of any other party thereto (other than the Borrower or any of its affiliates) after giving effect to the applicable
anti-assignment provisions of the Uniform Commercial Code or other similar applicable law, other than proceeds and receivables thereof, the assignment of which is expressly deemed effective under the Uniform Commercial Code or other similar
applicable law notwithstanding such prohibition, (vii)&nbsp;Equity Interests in any Foreign Subsidiary or FSHCO that would not qualify as &#147;Collateral&#148; under clause (b)&nbsp;of such definition and (viii)&nbsp;assets held by any Foreign
Subsidiaries of the Borrower.&nbsp;The Collateral may also exclude those assets as to which the Administrative Agent and the Borrower reasonably agree in writing that the cost of obtaining such a security interest or perfection thereof is excessive
in relation to the benefit to the Lenders of the security to be afforded thereby. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Excluded Swap Obligation</U>&#148; shall mean,
with respect to any Guarantor, any obligation to pay or perform under any agreement, contract, or transaction that constitutes a &#147;swap&#148; within the meaning of section 1a(47) of the Commodity Exchange Act (any such obligation, a
&#147;<U>Swap Obligation</U>&#148;), if, and to the extent that, all or a portion of the guarantee of such Guarantor pursuant to the Guarantee of, or the grant by such Guarantor of a security interest to secure, such Swap Obligation (or any
guarantee pursuant to the Guarantee thereof) is or becomes illegal under the Commodity Exchange Act or any rule, regulation, or order of the Commodity Futures Trading Commission (or the application or official interpretation of any thereof). </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>

</DIV></Center>


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


<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">&#147;<U>Excluded Taxes</U>&#148; shall mean, with respect to the Administrative Agent, any
Lender, any Issuing Lender or any other recipient of any payment to be made by or on account of any obligation of the Borrower hereunder or under any other Credit Document, (a)&nbsp;taxes imposed on or measured by its net income (however
denominated), and franchise taxes imposed on it (in lieu of net income taxes), by any jurisdiction (or any political subdivision thereof) as a result of such recipient being organized under the laws of or having its principal office or, in the case
of any Lender, an applicable lending office in the jurisdiction imposing such Tax (or any political subdivision thereof) or as a result of any other present or former connection other than a connection resulting at least in part from this Agreement,
any other Credit Document, or any actions related thereto, (b)&nbsp;any United States branch profits taxes, or any similar tax, imposed by any jurisdiction described in (a), (c) any United States federal backup withholding tax imposed under
Section&nbsp;3406 of the Code, (d)&nbsp;in the case of a Foreign Lender (other than a Foreign Lender becoming a party hereto pursuant to the Borrower&#146;s request under Section&nbsp;2.19), any United States federal withholding tax that is imposed
on amounts payable to such Foreign Lender pursuant to a law in effect at the time such Foreign Lender becomes a party hereto (or designates a new lending office), except to the extent that such Foreign Lender (or its assignor, if any) was entitled,
immediately prior to the time of designation of a new lending office (or assignment), to receive additional amounts from the Borrower with respect to such withholding tax pursuant to Section&nbsp;2.16, (e) any withholding tax attributable to a
Lender&#146;s failure to comply with Section&nbsp;2.16(e) or (f), and (f)&nbsp;any withholding tax to the extent imposed pursuant to FATCA. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Existing Credit Agreement</U>&#148; means the Credit Agreement, dated as of October&nbsp;29, 2014, as amended by Amendment No.&nbsp;1
dated as of June&nbsp;5, 2015 and as further amended or otherwise modified prior to the date hereof, among the Borrower, the guarantors party thereto, the lenders party thereto and JPMorgan Chase Bank, N.A., as administrative agent. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Existing Lenders</U>&#148; means the lenders party to the Existing Credit Agreement. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Existing Letter of Credit</U>&#148; shall mean each of the letters of credit described by applicant, date of issuance, letter of
credit number, amount, beneficiary and the date of expiry on <U>Schedule 1.1(c)</U> hereto. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Extension of Credit</U>&#148; shall
mean, as to any Lender, the making of a Loan by such Lender, any conversion of a Loan from one Type to another Type, any extension of any Loan or the issuance, extension or renewal of, or participation in, a Letter of Credit by such Lender. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Facility</U>&#148; shall mean an Incremental Facility and/or the Revolving Facility, as appropriate. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>FATCA</U>&#148; means Sections 1471 through 1474 of the Code, as of the date of this Agreement (or any amended or successor version
that is substantively comparable and not materially more onerous to comply with or any agreements entered into pursuant to Section&nbsp;1471(b)(1) of the Code) and any current or future regulations or official interpretations thereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Federal Funds Effective Rate</U>&#148; means, for any day, the weighted average (rounded upwards, if necessary, to the next 1/100 of
1%) of the rates on overnight Federal funds transactions with members of the Federal Reserve System arranged by Federal funds brokers, as published on the next succeeding Business Day by the Federal Reserve Bank of New York, or, if such rate is not
so published for any day that is a Business Day, the average (rounded upwards, if necessary, to the next 1/100 of 1%) of the quotations for such day for such transactions received by the Administrative Agent from three Federal funds brokers of
nationally recognized standing selected by it; <U>provided</U>, that, if the Federal Funds Effective Rate shall be less than zero, such rate shall be deemed to be zero for purposes of this Agreement. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Fee Letters</U>&#148; shall mean, collectively, (a)&nbsp;the fee letter agreement dated October&nbsp;23, 2017, addressed to the
Borrower from JPMCB, as amended, modified, extended, restated, replaced, or supplemented from time to time and (b) any other fee letter entered into prior to the Closing Date with any Agent or Arranger relating to this Credit Agreement. </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>

</DIV></Center>


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


<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">&#147;<U>Foreign Lender</U>&#148; shall mean any Lender that is not a &#147;United States
person&#148; as defined in Section&nbsp;7701(a)(30) of the Code. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Foreign Subsidiary</U>&#148; shall mean any Subsidiary that is
not a Domestic Subsidiary. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Fronting Exposure</U>&#148; shall mean, at any time there is a Defaulting Lender, with respect to the
Issuing Lenders, such Defaulting Lender&#146;s Commitment Percentage of the outstanding LOC Obligations with respect to Letters of Credit issued by the Issuing Lenders other than LOC Obligations as to which such Defaulting Lender&#146;s
participation obligation has been reallocated to other Lenders or Cash Collateralized in accordance with the terms hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>FSHCO</U>&#148; shall mean any Domestic Subsidiary that owns no material assets other than the capital stock of one or more Foreign
Subsidiaries that are &#147;controlled foreign corporations&#148; within the meaning of Section&nbsp;957 of the Code. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Fund</U>&#148; shall mean any Person (other than a natural person) that is (or will be) engaged in making, purchasing, holding or
otherwise investing in commercial loans and similar extensions of credit in the ordinary course of its business. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Funded
Debt</U>&#148; shall mean, with respect to any Person, without duplication, all Indebtedness of such Person (other than Indebtedness set forth in clauses (e)&nbsp;and (i) of such definition). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>GAAP</U>&#148; shall mean generally accepted accounting principles in effect in the United States of America (or, in the case of
Foreign Subsidiaries with significant operations outside the United States of America, generally accepted accounting principles in effect from time to time in their respective jurisdictions of organization or formation) applied on a consistent
basis, <U>subject</U>, <U>however</U>, in the case of determination of compliance with the financial covenants set out in Section&nbsp;5.9 to the provisions of Section&nbsp;1.3. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Global Intercompany Note</U>&#148; shall mean a promissory note, in form and substance satisfactory to the Administrative Agent,
evidencing all intercompany loans at any time owed by any Credit Party to the Borrower or any of its Subsidiaries, declaring such loans to be subordinate in all respects to the payment of the Obligations at any time owing to the Lenders. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Government Acts</U>&#148; shall have the meaning set forth in Section&nbsp;2.17(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Government Obligations</U>&#148; shall have the meaning set forth in the definition of &#147;Cash Equivalents.&#148; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Government Reimbursement Program</U>&#148; shall mean (to the extent that any Credit Party participates in one or more of the
following): (a) Medicare, the Federal Employees Health Benefit Program under 5&nbsp;U.S.C. &#167;&#167;&nbsp;8902 <I>et seq</I>., the TRICARE program established by the Department of Defense under 10&nbsp;U.S.C. &#167;&#167;&nbsp;1071 <I>et seq</I>.
or the Civilian Health and Medical Program of the Uniformed Services under 10&nbsp;U.S.C. &#167;&#167;&nbsp;1079 and 1086, (b) Medicaid or (c)&nbsp;any agent, administrator, intermediary or carrier for any of the foregoing. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Governmental Authority</U>&#148; shall mean the government of the United States of America or any other nation, or of any political
subdivision thereof, whether state or local, and any agency, authority, instrumentality, regulatory body, court, central bank or other entity exercising executive, legislative, judicial, taxing, regulatory or administrative powers or functions of or
pertaining to government (including any supra-national bodies such as the European Union or the European Central Bank) and any group or body charged with setting financial accounting or regulatory capital rules or standards (including, without
limitation, the Financial Accounting Standards Board, the Bank for International Settlements or the Basel Committee on Banking Supervision or any successor or similar authority to any of the foregoing). </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>

</DIV></Center>


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


<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">&#147;<U>Guarantor</U>&#148; shall mean the Domestic Subsidiaries of the Borrower as are, or
may from time to time become parties to this Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Guaranty</U>&#148; shall mean the guaranty of the Guarantors set forth
in <U>Article X</U>. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Guaranty Obligations</U>&#148; shall mean, with respect to any Person, without duplication, any obligations
of such Person (other than endorsements in the ordinary course of business of negotiable instruments for deposit or collection) guaranteeing or intended to guarantee any Indebtedness of any other Person in any manner, whether direct or indirect, and
including, without limitation, any obligation, whether or not contingent, (a)&nbsp;to purchase any such Indebtedness or any property constituting security therefor, (b)&nbsp;to advance or provide funds or other support for the payment or purchase of
any such Indebtedness or to maintain working capital, solvency or other balance sheet condition of such other Person (including, without limitation, keep well agreements, maintenance agreements, comfort letters or similar agreements or arrangements)
for the benefit of any holder of Indebtedness of such other Person, (c)&nbsp;to lease or purchase property, securities or services primarily for the purpose of assuring the holder of such Indebtedness, or (d)&nbsp;to otherwise assure or hold
harmless the holder of such Indebtedness against loss in respect thereof. The amount of any Guaranty Obligation hereunder shall (subject to any limitations set forth therein) be deemed to be an amount equal to the outstanding principal amount (or
maximum principal amount, if larger) of the Indebtedness in respect of which such Guaranty Obligation is made. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Healthcare
Laws</U>&#148; shall mean, collectively, any and all federal, state or local laws, rules, regulations and to the extent publicly available to providers, administrative manuals, orders, guidelines and requirements issued under or in connection with
Medicare, Medicaid or any Government Reimbursement Program, or any law governing the licensure of or regulating healthcare providers, professionals, facilities or payors or otherwise governing or regulating the provision of, or payment for, medical
services, including, without limitation, the delivery of home healthcare services by the Credit Parties and any other medical, nursing or other patient-related services now or hereafter provided by the Credit Parties. Healthcare Laws include, but
are not limited to, HIPAA; 31 U.S.C. Section&nbsp;3729, <I>et seq</I>.; 42 U.S.C. <FONT STYLE="white-space:nowrap">Section&nbsp;1320a-7(b);</FONT> and 42 U.S.C. 1395nn. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Hedging Agreements</U>&#148; shall mean, with respect to any Person, any agreement entered into to protect such Person against
fluctuations in interest rates, or currency or raw materials values, including, without limitation, any interest rate swap, cap or collar agreement or similar arrangement between such Person and one or more counterparties, any foreign currency
exchange agreement, currency protection agreements, commodity purchase or option agreements or other interest or exchange rate hedging agreements. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>HIPAA</U>&#148; shall mean the (a)&nbsp;Health Insurance Portability and Accountability Act of 1996; (b)&nbsp;the Health Information
Technology for Economic and Clinical Health Act (Title XIII of the American Recovery and Reinvestment Act of 2009); and (c)&nbsp;any state and local laws regulating the privacy and/or security of individually identifiable information, including
state laws providing for notification of breach of privacy or security of individually identifiable information, in each case with respect to the laws described in clauses (a), (b) and (c)&nbsp;of this definition, as the same may be amended,
modified or supplemented from time to time, any successor statutes thereto, any and all rules or regulations promulgated from time to time thereunder. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Holder Purchase Grant</U>&#148; shall have the meaning set forth in Section&nbsp;9.23(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Increased Revolver Commitment</U>&#148; shall have the meaning set forth in Section&nbsp;2.22(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Incremental Facility</U>&#148; shall have the meaning set forth in Section&nbsp;2.22(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Incremental Facility Commitment</U>&#148; shall have the meaning set forth in Section&nbsp;2.22(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Incremental Lender</U>&#148; shall have the meaning set forth in Section&nbsp;2.22(c). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Incremental Loans</U>&#148; shall have the meaning set forth in Section&nbsp;2.22(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Incremental Commitments</U>&#148; shall have the meaning set forth in Section&nbsp;2.22(a). </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>

</DIV></Center>


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


<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">&#147;<U>Indebtedness</U>&#148; shall mean, with respect to any Person, without duplication,
(a)&nbsp;all obligations of such Person for borrowed money, (b)&nbsp;all obligations of such Person evidenced by bonds, debentures, notes or similar instruments, or upon which interest payments are customarily made, (c)&nbsp;all obligations of such
Person under conditional sale or other title retention agreements relating to property purchased by such Person (other than customary reservations or retentions of title under agreements with suppliers entered into in the ordinary course of
business), (d)&nbsp;all obligations (including, without limitation, earnout obligations) of such Person incurred, issued or assumed as the deferred purchase price of property or services purchased by such Person (other than trade debt incurred in
the ordinary course of business and due within six months of the incurrence thereof) which would appear as liabilities on a balance sheet of such Person, (e)&nbsp;all obligations of such Person under <FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">take-or-pay</FONT></FONT> or similar arrangements or under commodities agreements, (f)&nbsp;all Indebtedness of others secured by (or for which the holder of such Indebtedness has an existing right, contingent or
otherwise, to be secured by) any Lien on, or payable out of the proceeds of production from, property owned or acquired by such Person, whether or not the obligations secured thereby have been assumed, (g)&nbsp;all Guaranty Obligations of such
Person with respect to Indebtedness of another Person, (h)&nbsp;the principal portion of all Capital Lease Obligations <U>plus</U> any accrued interest thereon, (i)&nbsp;the Swap Termination Value of all Hedging Agreements of such Person,
(j)&nbsp;the maximum amount of all letters of credit issued or bankers&#146; acceptances facilities created for the account of such Person and, without duplication, all drafts drawn thereunder (to the extent unreimbursed), (k)&nbsp;all preferred
Equity Interest issued by such Person and which by the terms thereof could be (at the request of the holders thereof or otherwise) subject to mandatory sinking fund payments, redemption or other acceleration, (l)&nbsp;the principal balance
outstanding under any synthetic lease, tax retention operating lease, <FONT STYLE="white-space:nowrap">off-balance</FONT> sheet loan or similar <FONT STYLE="white-space:nowrap">off-balance</FONT> sheet financing product <U>plus</U> any accrued
interest thereon and (m)&nbsp;all obligations of any partnership or unincorporated joint venture in which such Person is a general partner or a joint venturer to the extent such Indebtedness is recourse to such Person. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Indemnified Taxes</U>&#148; shall mean all Taxes imposed on or with respect to any payment made by or on account of any obligation of
any Credit Party under any Credit Document, other than Excluded Taxes. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Indemnitee</U>&#148; shall have the meaning set forth in
Section&nbsp;9.5(b). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Insolvency</U>&#148; shall mean, with respect to any Multiemployer Plan, the condition that such Plan is
insolvent within the meaning of such term as used in Section&nbsp;4245 of ERISA. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Intellectual Property</U>&#148; shall mean,
collectively, all Copyrights, Copyright Licenses, Patents, Patent Licenses, Trademarks and Trademark Licenses of the Credit Parties and their Subsidiaries, all goodwill associated therewith and all rights to sue for infringement thereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Interest Coverage Ratio</U>&#148; shall mean, as of the last day of any fiscal quarter of the Borrower, for the Credit Parties and
their Subsidiaries on a Consolidated basis, the ratio of (a)&nbsp;Consolidated EBITDA to (b)&nbsp;Consolidated Interest Expense paid or payable in cash during the four consecutive fiscal quarter period ending on such date. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Interest Determination Date</U>&#148; shall have the meaning specified in the definition of &#147;Applicable Margin.&#148; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Interest Payment Date</U>&#148; shall mean (a)&nbsp;as to any Alternate Base Rate Loan, the last Business Day of each March, June,
September and December, (b)&nbsp;as to any LIBOR Rate Loan having an Interest Period of three months or less, the last day of such Interest Period, (c)&nbsp;as to any LIBOR Rate Loan having an Interest Period longer than three months, (i)&nbsp;each
three (3)&nbsp;month anniversary following the first day of such Interest Period and (ii)&nbsp;the last day of such Interest Period, (d)&nbsp;as to any Loan which is the subject of a mandatory prepayment required pursuant to Section&nbsp;2.7(b), the
date on which such mandatory prepayment is due, and (e)&nbsp;as to any Loan then outstanding, on the Maturity Date. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Interest
Period</U>&#148; shall mean, with respect to any LIBOR Rate Loan, </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) initially, the period commencing on the Borrowing
Date or conversion date, as the case may be, with respect to such LIBOR Rate Loan and ending one, two, three or six months thereafter, subject to availability to all applicable Lenders, as selected by the Borrower in the Notice of Borrowing or
Notice of Conversion given with respect thereto; and </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">15 </P>

</DIV></Center>


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


<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">(b) thereafter, each period commencing on the last day of the immediately
preceding Interest Period applicable to such LIBOR Rate Loan and ending one, two, three or six months thereafter, subject to availability to all applicable Lenders, as selected by the Borrower by irrevocable notice to the Administrative Agent not
less than three (3)&nbsp;Business Days prior to the last day of the then current Interest Period with respect thereto; <U>provided</U> that the foregoing provisions are subject to the following: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) if any Interest Period pertaining to a LIBOR Rate Loan would otherwise end on a day that is not a Business Day, such
Interest Period shall be extended to the next succeeding Business Day unless the result of such extension would be to carry such Interest Period into another calendar month in which event such Interest Period shall end on the immediately preceding
Business Day; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) any Interest Period pertaining to a LIBOR Rate Loan that begins on the last Business Day of a calendar
month (or on a day for which there is no numerically corresponding day in the calendar month at the end of such Interest Period) shall end on the last Business Day of the relevant calendar month; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) if the Borrower shall fail to give notice as provided above, the Borrower shall be deemed to have selected an Alternate
Base Rate Loan to replace the affected LIBOR Rate Loan; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iv) no Interest Period in respect of any Revolving Loans shall
extend beyond the Maturity Date; and </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(v) no more than ten (10)<B></B>&nbsp;LIBOR Rate Loans may be in effect at any time.
For purposes hereof, LIBOR Rate Loans with different Interest Periods shall be considered as separate LIBOR Rate Loans, even if they shall begin on the same date, although borrowings, extensions and conversions may, in accordance with the provisions
hereof, be combined at the end of existing Interest Periods to constitute a new LIBOR Rate Loan with a single Interest Period. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Interpolated Rate</U>&#148; means, at any time, for any Interest Period, the rate per annum (rounded to the same number of decimal
places as the LIBO Screen Rate) determined by the Administrative Agent (which determination shall be conclusive and binding absent manifest error) to be equal to the rate that results from interpolating on a linear basis between: (a)&nbsp;the LIBO
Screen Rate for the longest period for which the LIBO Screen Rate is available for Dollars) that is shorter than the Impacted Interest Period; and (b)&nbsp;the LIBO Screen Rate for the shortest period (for which that LIBO Screen Rate is available
for Dollars) that exceeds the Impacted Interest Period, in each case, at such time. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Investment</U>&#148; shall mean (a)&nbsp;the
acquisition (whether for cash, property, services, assumption of Indebtedness, securities or otherwise) of shares of Equity Interest, other ownership interests or other securities of any Person or bonds, notes, debentures or all or substantially all
of the assets of any Person <U STYLE="border-bottom:1pt double; padding-bottom:1pt">(including pursuant to any merger with, or as a Division Successor pursuant to the Division of, any Person that was not a wholly-owned Subsidiary prior to such
merger or Division)</U>, (b)&nbsp;any deposit with, or advance, loan or other extension of credit to, any Person (other than deposits made in the ordinary course of business) or (c)&nbsp;any other capital contribution to or investment in any Person,
including, without limitation, any Guaranty Obligation (including any support for a letter of credit issued on behalf of such Person) incurred for the benefit of such Person. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Issuing Lender</U>&#148; shall mean, with respect to Letters of Credit, (a)&nbsp;each of JPMCB (including in its capacity as issuing
lender under any Existing Letter of Credit), Wells Fargo Bank, National Association (including in its capacity as issuing lender under any Existing Letter of Credit), Bank of America, N.A., The Bank of Tokyo-Mitsubishi UFJ, Ltd., SunTrust Bank,
Mizuho Bank, Ltd. and Fifth Third Bank, together with any successor thereto and (b)&nbsp;each Successor Issuing Lender. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Issuing
Lender Fees</U>&#148; shall have the meaning set forth in Section&nbsp;2.5(c). </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>

</DIV></Center>


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


<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">&#147;<U>Issuing Lender Sublimit</U>&#148; shall mean, (a)&nbsp;with respect to each initial
Issuing Lender, $7,500,000, as such amount may be modified pursuant to a Successor Issuing Lender Agreement and (b)&nbsp;with respect to any Successor Issuing Lender, such amount as specified in the applicable Successor Issuing Lender Agreement.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Joinder Agreement</U>&#148; shall mean a Joinder Agreement in substantially the form of
<U>Exhibit</U><U></U><U>&nbsp;1.1(c)</U>, executed and delivered by an Additional Credit Party in accordance with the provisions of Section&nbsp;5.10. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Joint Commission</U>&#148; shall mean<B> </B>the Joint Commission (formerly known as the Joint Commission on Accreditation of
Healthcare Organizations). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>JPMCB</U>&#148; shall mean JPMorgan Chase Bank, N.A., together with its successors and/or assigns.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>JPMS</U>&#148; shall mean J. P. Morgan Securities LLC, together with its successors and/or assigns. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Lender</U>&#148; shall mean any of the several banks and other financial institutions as are, or may from time to time become parties
to this Agreement; <U>provided</U> that notwithstanding the foregoing, &#147;Lender&#148; shall not include any Credit Party or any of the Credit Party&#146;s Affiliates or Subsidiaries. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Lender Consent</U>&#148; shall mean any lender consent delivered by a Lender on the Closing Date in the form of <U>Exhibit
4.1(a)</U>. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Letter of Credit</U>&#148; shall mean (a)&nbsp;any letter of credit issued by any Issuing Lender pursuant to the
terms hereof, as such letter of credit may be amended, modified, restated, extended, renewed, increased, replaced or supplemented from time to time and (b)&nbsp;any Existing Letter of Credit, in each case as such letter of credit may be amended,
modified, extended, renewed or replaced from time to time. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Letter of Credit Facing Fee</U>&#148; shall have the meaning set
forth in Section&nbsp;2.5(c). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Letter of Credit Fee</U>&#148; shall have the meaning set forth in Section&nbsp;2.5(b). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>LIBO Screen Rate</U>&#148; shall have the meaning assigned to such term in the definition of LIBOR. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>LIBOR</U>&#148; shall mean, for any LIBOR Rate Loan for any Interest Period therefor, the rate per annum (rounded upwards, if
necessary, to the nearest 1/100 of 1%) appearing on pages LIBOR01 or LIBOR02 of the Reuters screen (or any successor page) as the London interbank offered rate as administered by ICE Benchmark Association (or any other Person that takes over the
administration of such rate) for deposits in Dollars at approximately 11:00 a.m. (London time) two (2)&nbsp;Business Days prior to the first day of such Interest Period for a term comparable to such Interest Period; <U>provided</U> that if the rate
per annum appearing on pages LIBOR01 or LIBOR02 of the Reuters screen (or any successor page) shall be less than zero, such rate shall be deemed to be zero for the purposes of this Agreement (such London interbank offered rate, the &#147;<U>LIBO
Screen Rate</U>&#148;). If for any reason such LIBO Screen Rate is not available at such time for such Interest Period (an &#147;<U>Impacted Interest Period</U>&#148;), then &#147;LIBOR&#148; for such Impacted Interest Period shall mean the
Interpolated Rate. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>LIBOR Lending Office</U>&#148; shall mean, initially, the office(s) of each Lender designated as such
Lender&#146;s LIBOR Lending Office in such Lender&#146;s Administrative Questionnaire; and thereafter, such other office of such Lender as such Lender may from time to time specify to the Administrative Agent and the Borrower as the office of such
Lender at which the LIBOR Rate Loans of such Lender are to be made. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>LIBOR Rate</U>&#148; shall mean, for any Interest Period, a
rate per annum (rounded upwards, if necessary, to the next higher 1/100th of 1%) determined by the Administrative Agent pursuant to the following formula: </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="11%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="43%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="42%"></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">LIBOR&nbsp;Rate=</P></TD>
<TD VALIGN="bottom" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center" STYLE="BORDER-BOTTOM:1px solid #000000">LIBOR</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1.0 minus the Eurodollar Reserve Percentage</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom"></TD></TR>
</TABLE> <P STYLE="font-size:6pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</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">17 </P>

</DIV></Center>


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


<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">&#147;<U>LIBOR Rate Loan</U>&#148; shall mean Loans the rate of interest applicable to which
is based on the LIBOR Rate. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>LIBOR Tranche</U>&#148; shall mean the collective reference to LIBOR Rate Loans whose Interest
Periods begin and end on the same day. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Lien</U>&#148; shall mean any mortgage, pledge, hypothecation, assignment, deposit
arrangement, encumbrance, lien (statutory or other), charge or other security interest or any preference, priority or other security agreement or preferential arrangement of any kind or nature whatsoever (including, without limitation, (a)&nbsp;any
conditional sale or other title retention agreement and any Capital Lease having substantially the same economic effect as any of the foregoing and (b)&nbsp;the filing of, or the agreement to give, any UCC financing statement). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">&#147;LLC&#148; means any Person that is a limited liability company under the laws of
its jurisdiction of formation.</U> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Loan</U>&#148; or &#147;<U>Loans</U>&#148; shall mean a Revolving Loan and/or an Incremental
Loan, as appropriate. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>LOC Commitment</U>&#148; shall mean (a)&nbsp;with respect to each Issuing Lender&#146;s commitment to
issue Letters of Credit, such Issuing Lender&#146;s Issuing Lender Sublimit and (b)&nbsp;with respect to each Revolving Lender, the commitment of such Revolving Lender to purchase Participation Interests in the Letters of Credit up to such Revolving
Lender&#146;s Revolving Commitment Percentage of the LOC Committed Amount. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>LOC Committed Amount</U>&#148; shall have the meaning
set forth in Section&nbsp;2.3(a). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>LOC Documents</U>&#148; shall mean, with respect to each Letter of Credit, such Letter of
Credit, any amendments thereto, any documents delivered in connection therewith, any application therefor, and any agreements, instruments, guarantees or other documents (whether general in application or applicable only to such Letter of Credit)
governing or providing for (a)&nbsp;the rights and obligations of the parties concerned or (b)&nbsp;any collateral for such obligations. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>LOC Obligations</U>&#148; shall mean, at any time, the sum of (a)&nbsp;the maximum amount which is, or at any time thereafter may
become, available to be drawn under Letters of Credit then outstanding, assuming compliance with all requirements for drawings referred to in such Letters of Credit <U>plus</U> (b)&nbsp;the aggregate amount of all drawings under Letters of Credit
honored by the Issuing Lenders but not theretofore reimbursed. For purposes of computing the amount available to be drawn under any Letter of Credit, the amount of such Letter of Credit shall be determined in accordance with Section&nbsp;1.6. For
all purposes of this Agreement, if on any date of determination a Letter of Credit has expired by its terms but any amount may still be drawn thereunder by reason of the operation of Rule 3.14 of the ISP, such Letter of Credit shall be deemed to be
&#147;outstanding&#148; in the amount so remaining available to be drawn. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Management Agreement</U>&#148; shall mean each
agreement pursuant to which a Manager agrees to provide certain administrative services to a Practice. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Manager</U>&#148; shall
mean, with respect to any particular Management Agreement, the Borrower or its applicable Subsidiary that is a party to such Management Agreement as the administrative manager of the relevant medical practice or practices. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Mandatory LOC Borrowing</U>&#148; shall have the meaning set forth in Section&nbsp;2.3(e). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Material Adverse Effect</U>&#148; shall mean a material adverse effect on (a)&nbsp;the business, operations, property, assets or
financial condition of the Credit Parties and their Subsidiaries taken as a whole, (b)&nbsp;the ability of the Credit Parties and their Subsidiaries taken as a whole to perform their obligations, when such obligations are required to be performed,
under this Agreement, any of the Notes or any other Credit Document or (c)&nbsp;the validity or enforceability of this Agreement, any of the Notes, any Joinder Agreement, any of the Letters of Credit, the LOC Documents or the Security Documents (if
any) or the rights or remedies of the Administrative Agent or the Lenders hereunder or thereunder. The inclusion of any dollar amount threshold in any representation, warranty, covenant, notice provision, Default or Event of Default or any other
provision of this Agreement shall not be deemed to constitute a mutual agreement as to a standard that is determinative of whether a Material Adverse Effect exists or may exist. </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>

</DIV></Center>


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


<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">&#147;<U>Material Contract</U>&#148; shall mean (a)&nbsp;any Management Agreement and any
Restrictive Agreement and (b)&nbsp;any other contract, agreement, permit or license, written or oral, of the Credit Parties or any of their Subsidiaries as to which the breach, nonperformance, cancellation or failure to renew by any party thereto,
individually or in the aggregate, could reasonably be expected to have a Material Adverse Effect. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Material Domestic
Subsidiary</U>&#148; shall mean any Domestic Subsidiary of the Borrower that, together with its Subsidiaries, (a)&nbsp;generated more than 10% of the net revenues (whether denominated in the financial statements of the Credit Parties as net patient
service revenues or similar nomenclature) of the Credit Parties on a Consolidated basis for the four (4)&nbsp;fiscal quarter period most recently ended or (b)&nbsp;owns more than 10% of the Consolidated Assets as of the last day of the most recently
ended fiscal quarter of the Borrower; <U>provided</U>, <U>however</U>, that if at any time there are Domestic Subsidiaries which are not classified as &#147;Material Domestic Subsidiaries&#148; but which collectively (i)&nbsp;generated more than 20%
of the net revenues (whether denominated in the financial statements of the Credit Parties as net patient service revenues or similar nomenclature) of the Credit Parties on a Consolidated basis for the four (4)&nbsp;fiscal quarters most recently
ended or (ii)&nbsp;own more than 20% of the Consolidated Assets as of the last day of the most recently ended fiscal quarter of the Borrower, then the Borrower shall promptly, and in any event within thirty (30)&nbsp;days after the financial
statements for such fiscal quarter become available, designate one or more of such Domestic Subsidiaries as Material Domestic Subsidiaries and cause any such Domestic Subsidiaries to comply with the provisions of Section&nbsp;5.10 such that, after
such Domestic Subsidiaries become Guarantors hereunder, the Domestic Subsidiaries that are not Guarantors shall (iii)&nbsp;generate less than 20% of the net revenues (whether denominated in the financial statements of the Credit Parties as net
patient service revenues or similar nomenclature) of the Credit Parties and (iv)&nbsp;own less than 20% of the Consolidated Assets. For purposes of determining whether or not any newly formed or acquired Subsidiary is a &#147;Material Domestic
Subsidiary,&#148; the foregoing calculations shall be performed at the time of such acquisition or formation (including any asset contributions made to such Subsidiary concurrently with such acquisition or formation) giving effect to such
acquisition or formation (including any asset contributions made to such Subsidiary concurrently with such acquisition or formation) on a Pro Forma Basis as of the last day of the most recently ended fiscal quarter of the Borrower. It is understood
and agreed that in no event shall PMG be considered a Material Domestic Subsidiary. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Materials of Environmental Concern</U>&#148;
shall mean any gasoline or petroleum (including crude oil or any extraction thereof) or petroleum products or any hazardous or toxic substances, materials or wastes, defined or regulated as such in or under any Environmental Law, including, without
limitation, asbestos, perchlorate, polychlorinated biphenyls and urea-formaldehyde insulation. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Maturity Date</U>&#148; shall
mean October&nbsp;31, 2022; <U>provided</U>, <U>however</U>, if such date is not a Business Day, the Maturity Date shall be the next preceding Business Day. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Medicaid</U>&#148; means the medical assistance programs administered by state agencies and approved by CMS pursuant to the terms of
Title&nbsp;XIX of the Social Security Act, codified at 42&nbsp;U.S.C. 1396 <I>et seq</I>. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Medicare</U>&#148; means the program
of health benefits for the aged and disabled administered by CMS pursuant to the terms of Title&nbsp;XVIII of the Social Security Act, codified at 42&nbsp;U.S.C. 1395 <I>et seq</I>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Moody&#146;s</U>&#148; shall mean Moody&#146;s Investors Service, Inc. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Multiemployer Plan</U>&#148; shall mean a Plan that is a multiemployer plan as defined in Section&nbsp;4001(a)(3) of ERISA. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U><FONT STYLE="white-space:nowrap">Non-Consenting</FONT> Lender</U>&#148; shall mean any Lender (other than JPMCB) that does not
approve any consent, waiver or amendment that has been obtained as to one or more Lenders and that is not effective with respect to an affected Lender not approving such consent, waiver or amendment in accordance with the terms of Section&nbsp;9.1.
</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>

</DIV></Center>


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


<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">&#147;<U><FONT STYLE="white-space:nowrap">Non-Defaulting</FONT> Lender</U>&#148; shall mean,
at any time, each Lender that is not a Defaulting Lender at such time. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Note</U>&#148; or &#147;<U>Notes</U>&#148; shall mean the
Revolving Notes, collectively or individually, as appropriate. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Notice of Borrowing</U>&#148; shall mean a request for a
Revolving Loan borrowing pursuant to Section&nbsp;2.1(b)(i).. A Form of Notice of Borrowing is attached as <U>Exhibit</U><U></U><U>&nbsp;1.1(d)</U>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Notice of Conversion/Extension</U>&#148; shall mean the written notice of conversion of a LIBOR Rate Loan to an Alternate Base Rate
Loan or an Alternate Base Rate Loan to a LIBOR Rate Loan, or extension of a LIBOR Rate Loan, in each case substantially in the form of <U>Exhibit</U><U></U><U>&nbsp;1.1(e)</U>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Obligations</U>&#148; shall mean, collectively, all of the obligations, Indebtedness and liabilities of the Credit Parties to the
Lenders (including the Issuing Lenders) and the Administrative Agent, whenever arising, under this Agreement, the Notes or any of the other Credit Documents, including principal, interest, fees, costs, charges, expenses, professional fees,
reimbursements, all sums chargeable to the Credit Parties or for which any Credit Party is liable as an indemnitor and whether or not evidenced by a note or other instrument and indemnification obligations and other amounts (including, but not
limited to, any interest accruing after the occurrence of a filing of a petition of bankruptcy under the Bankruptcy Code with respect to any Credit Party, regardless of whether such interest is an allowed claim under the Bankruptcy Code).
Obligations with respect to any Guarantor shall in no event include any Excluded Swap Obligations of such Guarantor. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Operating
Lease</U>&#148; shall mean, as to any Person as determined in accordance with GAAP, any lease of property (whether real, personal or mixed) by such Person as lessee which is not a Capital Lease, or which is classified as an operating lease under the
definition of &#147;Capital Lease.&#148; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Other Taxes</U>&#148; shall mean all present or future stamp or documentary Taxes or
any other excise or property Taxes, charges or similar levies arising from any payment made hereunder or under any other Credit Document or from the execution, delivery or enforcement of, or otherwise with respect to, this Agreement or any other
Credit Document. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Participant</U>&#148; shall have the meaning assigned to such term in Section&nbsp;9.6(d). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Participant Register</U>&#148; shall have the meaning assigned to such term in Section&nbsp;9.6(d). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Participation Interest</U>&#148; shall mean a participation interest purchased by a Revolving Lender in LOC Obligations as provided
in Section&nbsp;2.3(c). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Patent Licenses</U>&#148; shall mean any agreement, whether written or oral, providing for the grant by
or to a Person of any right to manufacture, use or sell any invention covered by a Patent. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Patents</U>&#148; shall mean
(a)&nbsp;all letters patent of the United States or any other country, now existing or hereafter arising, and all improvement patents, reissues, reexaminations, patents of additions, renewals and extensions thereof and (b)&nbsp;all applications for
letters patent of the United States or any other country and all provisionals, divisions, continuations and <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">continuations-in-part</FONT></FONT> and substitutes thereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Patriot Act</U>&#148; shall mean Title III of The Uniting and Strengthening America by Providing Appropriate Tools Required to
Intercept and Obstruct Terrorism Act of 2001 (Title III of Pub. L. <FONT STYLE="white-space:nowrap">No.&nbsp;107-56</FONT> (signed into law October&nbsp;26, 2001)), as amended or modified from time to time. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>PBGC</U>&#148; shall mean the Pension Benefit Guaranty Corporation established pursuant to Subtitle A of Title IV of ERISA. </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>

</DIV></Center>


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


<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">&#147;<U>Permitted Acquisition</U>&#148; shall mean an acquisition
(<U STYLE="border-bottom:1pt double; padding-bottom:1pt">other than a Division</U>) or any series of related acquisitions by a Credit Party of (a)&nbsp;all or substantially all of the assets or a majority of the outstanding Voting Stock or economic
interests of a Person that is incorporated, formed or organized in the United States, (b)&nbsp;a Person that is incorporated, formed or organized in the United States by a merger, amalgamation or consolidation or any other combination with such
Person or (c)&nbsp;any division, line of business or other business unit of a Person that is incorporated, formed or organized in the United States (such Person or such division, line of business or other business unit of such Person shall be
referred to herein as the &#147;<U>Target</U>&#148;), in each case that is a type of business (or assets used in a type of business) permitted to be engaged in by the Credit Parties and their Subsidiaries pursuant to Section&nbsp;6.3, in each case
so long as: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) no Default or Event of Default shall then exist or would exist after giving effect thereto; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) the Credit Parties shall have furnished to the Administrative Agent within fifteen (15)&nbsp;Business Days after the
consummation of such acquisition (A)&nbsp;Consolidated pro forma financial statements of the Borrower (giving pro forma effect to all acquisitions made during the previous four fiscal quarter period as if they had occurred on the first day of such
period) as of the most recent date that financial statements have been furnished pursuant to Section&nbsp;5.1(a) or (b)&nbsp;demonstrating that, after giving effect to the acquisition on a Pro Forma Basis, the Credit Parties are in compliance with
each of the financial covenants set forth in Section&nbsp;5.9 and (B)&nbsp;a certificate substantially in the form of <U>Exhibit 1.1(f)</U> executed by a Responsible Officer of the Borrower certifying that such Permitted Acquisition complies with
the requirements of this Agreement; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) the Target, if a Person, shall have executed a Joinder Agreement to the extent
required by the terms of Section&nbsp;5.10 within the applicable time period specified in Section&nbsp;5.10; and </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iv) the
Target does not oppose such acquisition (other than in the case of an acquisition pursuant to a Holder Purchase Grant). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Permitted Investments</U>&#148; shall mean: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) cash and Cash Equivalents; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Investments existing as of the Closing Date as set forth on <U>Schedule</U><U></U><U>&nbsp;1.1(a)</U>, and any renewals,
refinancings or extensions thereof in a principal amount not in excess of that outstanding as of the date of such renewal, refinancing or extension; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) receivables owing to the Credit Parties or any of their Subsidiaries or any receivables and advances to suppliers, in each
case if created, acquired or made in the ordinary course of business and payable or dischargeable in accordance with customary trade terms; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) Investments in and loans to any Credit Party; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) Investments in and loans to Subsidiaries of Credit Parties (other than Credit Parties) and Permitted JV Investments in an
aggregate amount not to exceed at any one time 15% of Consolidated total shareholders&#146; equity as determined in accordance with GAAP and as set forth on the then most recent Consolidated balance sheet of the Borrower<B> </B>and its Consolidated
Subsidiaries furnished to the Administrative Agent pursuant to Section&nbsp;5.1(for the avoidance of doubt, the calculation of the aggregate amount of all Permitted JV Investments shall not include any accretion (or reduction) for equity in income
(loss) in any Permitted JV to the extent the financial results of such Permitted JV are not Consolidated with the financial results of the Borrower and its Subsidiaries except to the extent of dividends or distributions received in cash or Cash
Equivalents from a Permitted JV by a Credit Party or Subsidiary (other than another Permitted JV)); </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) loans and advances
to employees; <U>provided</U> that such loans and advances shall comply with all Requirements of Law (including Sarbanes-Oxley); </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>

</DIV></Center>


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


<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">(g) Investments (including debt obligations) received in connection with the
bankruptcy or reorganization of suppliers and customers and in settlement of delinquent obligations of, and other disputes with, customers and suppliers arising in the ordinary course of business; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(h) Investments, acquisitions or transactions permitted under
Section&nbsp;6.4<U STYLE="border-bottom:1pt double; padding-bottom:1pt">(a)(xiii) or Section&nbsp;6.4</U>(b) and Guaranty Obligations permitted under Section&nbsp;6.1; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) Permitted Acquisitions; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(j) Hedging Agreements to the extent permitted hereunder; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(k) Investments by PMG in accordance with applicable law and past practices; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(l) Investments in PMG (in addition to Investments in PMG outstanding on the Closing Date and set forth on Schedule 1.1(a)) in
an aggregate principal amount outstanding at any time not to exceed the greater of (i) $500,000,000 and (ii) 10.0% of Consolidated Total Assets at such time; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(m) additional loans, advances and/or Investments of a nature not contemplated by the foregoing clauses hereof so long as after
giving effect to each such additional loans, advances and/or Investments on a Pro Forma Basis the Consolidated Net Leverage Ratio of the Credit Parties would be less than or equal to 3.75 to 1.00. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Permitted JV</U>&#148; shall mean a Person that is (a)&nbsp;not a wholly-owned Subsidiary of the Borrower and (b)&nbsp;a type of
business (or assets used in a type of business) permitted to be engaged in by the Credit Parties and their Subsidiaries pursuant to Section&nbsp;6.3. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Permitted JV Investment</U>&#148; shall mean an Investment after the Closing Date in a Permitted JV (other than an Investment
pursuant to clause (b)&nbsp;of the definition of Permitted Investment) so long as no Default or Event of Default shall then exist or would exist after giving effect thereto. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Permitted Liens</U>&#148; shall mean: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Liens created by or otherwise existing under or in connection with this Agreement or the other Credit Documents in favor of
the Administrative Agent on behalf of the Lenders; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Liens in favor of a Bank Product Provider in connection with a Bank
Product; <U>provided</U> that such Liens shall secure the Credit Party Obligations on a ratable and pari passu basis; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c)
Liens securing purchase money Indebtedness and Capital Lease Obligations (and refinancings thereof) to the extent permitted under Section&nbsp;6.1(c); <U>provided</U>, that (i)&nbsp;any such Lien attaches to such property concurrently with or within
thirty (30)&nbsp;days after the acquisition thereof and (ii)&nbsp;such Lien attaches solely to the property so acquired in such transaction; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) Liens for taxes, assessments, charges or other governmental levies not yet due or as to which the period of grace (not to
exceed sixty (60)&nbsp;days), if any, related thereto has not expired or which are being contested in good faith by appropriate proceedings; <U>provided</U> that adequate reserves with respect thereto are maintained on the books of any Credit Party
or its Subsidiaries, as the case may be, in conformity with GAAP; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) statutory Liens such as carriers&#146;,
warehousemen&#146;s, mechanics&#146;, materialmen&#146;s, landlords&#146;, repairmen&#146;s or other like Liens arising in the ordinary course of business which are not overdue for a period of more than one hundred twenty (120)&nbsp;days or which
are being contested in good faith by appropriate proceedings; </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>

</DIV></Center>


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


<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">(f) pledges or deposits in connection with workers&#146; compensation,
unemployment insurance and other social security legislation (other than any Lien imposed by ERISA) and deposits securing liability to insurance carriers under insurance or self-insurance arrangements in accordance with historical practice and in
the ordinary course of business; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(g) deposits to secure the performance of bids, trade contracts (other than for borrowed
money), leases, statutory obligations, surety and appeal bonds, performance bonds and other obligations of a like nature incurred in the ordinary course of business; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(h) easements, rights of way, restrictions and other similar encumbrances affecting real property which, in the aggregate, are
not substantial in amount, and which do not in any case materially detract from the value of the property subject thereto or materially interfere with the ordinary conduct of the business of the applicable Person; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) Liens existing on the Closing Date and set forth on <U>Schedule</U><U></U><U>&nbsp;1.1(b)</U>; <U>provided</U> that
(i)&nbsp;no such Lien shall at any time be extended to cover property or assets other than the property or assets subject thereto on the Closing Date and subsequent improvements thereon, (ii)&nbsp;the principal amount of the Indebtedness secured by
such Lien shall not be extended, renewed, refunded or refinanced except as permitted by Section&nbsp;6.1(b) and (iii)&nbsp;the direct or any contingent obligor with respect thereto is not changed; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(j) any extension, renewal or replacement (or successive extensions, renewals or replacements), in whole or in part, of any
Lien referred to in this definition (other than Liens set forth on <U>Schedule 1.1(b)</U>); <U>provided</U> that such extension, renewal or replacement Lien shall be limited to all or a part of the property which secured the Lien so extended,
renewed or replaced (plus subsequent improvements on such property); </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(k) Liens arising in the ordinary course of business
by virtue of any contractual, statutory or common law provision relating to (i)&nbsp;landlord&#146;s Liens arising under leases of real property in the ordinary course of business and (ii)&nbsp;banker&#146;s Liens, rights of <FONT
STYLE="white-space:nowrap">set-off</FONT> or similar rights and remedies covering deposit or securities accounts (including funds or other assets credited thereto) or other funds maintained with a depository institution or securities intermediary;
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(l) any zoning, building or similar laws or rights reserved to or vested in any Governmental Authority; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(m) restrictions on transfers of securities imposed by applicable Securities Laws or laws governing the practice of medicine;
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(n) Liens arising out of judgments or awards not resulting in an Event of Default; <U>provided</U> that the applicable
Credit Party or Subsidiary shall in good faith be prosecuting an appeal or proceedings for review; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(o) Liens on the
property of a Person existing at the time such Person becomes a Subsidiary of a Credit Party in a transaction permitted hereunder securing Indebtedness in an aggregate principal amount not to exceed the greater of (i) $85,000,000 and (ii) 2.0% of
Consolidated Total Assets at such time, for all such Persons; <U>provided</U>, <U>however</U>, that any such Lien may not extend to any other property of any Credit Party or any other Subsidiary that is not a Subsidiary of such Person;
<U>provided</U>, <U>further</U>, that any such Lien was not created in anticipation of or in connection with the transaction or series of transactions pursuant to which such Person became a Subsidiary of a Credit Party; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(p) any interest or title of a lessor, licensor or sublessor under any lease, license or sublease entered into by any Credit
Party or any Subsidiary thereof in the ordinary course of its business and covering only the assets so leased, licensed or subleased; </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">23 </P>

</DIV></Center>


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


<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">(q) assignments of insurance or condemnation proceeds provided to landlords
(or their mortgagees) pursuant to the terms of any lease and Liens or rights reserved in any lease for rent or for compliance with the terms of such lease; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(r) Liens arising under Restrictive Agreements; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(s) Liens to the extent arising out of judgments, orders, attachments, decrees or awards not resulting in an Event of Default;
and </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(t) additional Liens so long as the aggregate principal amount of Indebtedness secured thereby at any time does not
exceed the greater of (i) $170,000,000 and (ii) 3.5% of Consolidated Total Assets at such time. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Person</U>&#148; shall mean any
natural person, corporation, limited liability company, trust, joint venture, association, company, partnership, Governmental Authority or other entity. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Plan</U>&#148; shall mean, as of any date of determination, any employee benefit plan which is covered by Title IV of ERISA and in
respect of which any Credit Party or a Commonly Controlled Entity is (or, if such plan were terminated at such time, would under Section&nbsp;4069 of ERISA be deemed to be) an &#147;employer&#148; as defined in Section&nbsp;3(5) of ERISA. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Platform</U>&#148; shall have the meaning set forth in Section&nbsp;9.2(d)(i). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>PMG</U>&#148; means PMG Indemnity Ltd., a corporation organized under the laws of Grand Cayman, British West Indies, and a Subsidiary
of the Borrower. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Practice</U>&#148; shall mean that Person party to any Management Agreement that is not the Manager under such
Management Agreement and that engages in the practice of providing medical services or of owning the Equity Interests of other Persons engaged in the practice of medical services. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Primary Syndication</U>&#148; shall mean any assignments by the Administrative Agent in order to effectuate the initial post-closing
syndication made on or prior to the earlier of (a)&nbsp;the date that is ninety (90)&nbsp;days after the Closing Date and (b)&nbsp;the completion of all assignments relating to the completion of a successful syndication. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Prime Rate</U>&#148; means the rate of interest per annum publicly announced from time to time by JPMCB as its prime rate in effect
at its office located at 270 Park Avenue, New York, New York, or any successor office announced by JPMCB; each change in the Prime Rate shall be effective from and including the date such change is publicly announced as being effective. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Private Payor</U>&#148;<B> </B>means any insurance company, health maintenance organization, preferred provider organization or
similar entity that is obligated to make payments for goods or services provided to a patient, but shall not include a Government Reimbursement Program. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Private Payor Arrangement</U>&#148;<B> </B>means a written agreement or arrangement with a Private Payor pursuant to which the
Private Payor pays all or a portion of the charges of any Credit Party for providing goods and services to a patient. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Pro Forma
Basis</U>&#148; shall mean, with respect to any transaction, that such transaction shall be deemed to have occurred as of the first day of the four-quarter period ending as of the Borrower&#146;s most recent fiscal quarter end preceding the date of
such transaction. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Properties</U>&#148; shall have the meaning set forth in Section&nbsp;3.10(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>PTE</U>&#148; means a prohibited transaction class exemption issued by the U.S. Department of Labor, as any such exemption may be
amended from time to time. </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">24 </P>

</DIV></Center>


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


<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">&#147;<U>Qualified ECP Guarantor</U>&#148; means, in respect of any Swap Obligation, each
Credit Party that has total assets exceeding $10,000,000 at the time the relevant Guaranty or grant of the relevant security interest becomes or would become effective with respect to such Swap Obligation or such other person as constitutes an
&#147;eligible contract participant&#148; under the Commodity Exchange Act or any regulations promulgated thereunder and can cause another person to qualify as an &#147;eligible contract participant&#148; at such time by entering into a keepwell
under Section&nbsp;1a(18)(A)(v)(II) of the Commodity Exchange Act. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Recipient</U>&#148; shall mean (a)&nbsp;the Administrative
Agent, (b)&nbsp;any Lender and (c)&nbsp;any Issuing Lender, as applicable. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Recovery Event</U>&#148; shall mean the receipt by
any Credit Party or its Subsidiaries of any cash insurance proceeds or condemnation award payable by reason of theft, loss, physical destruction or damage, taking or similar event with respect to any of their respective property or assets. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Register</U>&#148; shall have the meaning set forth in Section&nbsp;9.6(c). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Reimbursement Obligation</U>&#148; shall mean the obligation of the Borrower to reimburse the Issuing Lenders pursuant to
Section&nbsp;2.3(d) for amounts drawn under Letters of Credit. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Related Parties</U>&#148; shall mean, with respect to any Person,
such Person&#146;s Affiliates and the partners, directors, officers, employees, agents, trustees and advisors of such Person and of such Person&#146;s Affiliates. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Reorganization</U>&#148; shall mean, with respect to any Multiemployer Plan, the condition that such Plan is in reorganization within
the meaning of such term as used in Section&nbsp;4241 of ERISA. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Reportable Event</U>&#148; shall mean any of the events set
forth in Section&nbsp;4043(c) of ERISA, other than those events as to which the <FONT STYLE="white-space:nowrap">thirty-day</FONT> notice period is waived under PBGC Reg. &#167;4043. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Required Facility Lenders</U>&#148; shall mean, as of any date of determination, either (as the context may require)&nbsp;(a)
Revolving Lenders holding at least a majority of the outstanding Revolving Commitments and if the Revolving Commitments have been terminated, the outstanding Revolving Loans and Participation Interests, under the Revolving Facility, or
(b)&nbsp;Incremental Lenders holding at least a majority of the outstanding Loans and/or Commitments under an Incremental Facility; provided, however, that if any Lender shall be a Defaulting Lender at such time, then there shall be excluded from
the determination of Required Facility Lenders, Obligations (including Participation Interests) owing to such Defaulting Lender and such Defaulting Lender&#146;s Commitments. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Required Lenders</U>&#148; shall mean, as of any date of determination, Lenders holding at least a majority of (a)&nbsp;the
outstanding Commitments and Loans or (b)&nbsp;to the extent Commitments have been terminated, the outstanding Loans and Participation Interests; <U>provided</U>, <U>however</U>, that if any Lender shall be a Defaulting Lender at such time, then
there shall be excluded from the determination of Required Lenders, Obligations (including Participation Interests) owing to such Defaulting Lender and such Defaulting Lender&#146;s Commitments. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Requirement of Law</U>&#148; shall mean, as to any Person, (a)&nbsp;all international, foreign, Federal, state and local statutes,
treaties, rules, guidelines, regulations, ordinances, codes, executive orders, and administrative or judicial precedents or authorities, including the interpretation or administration thereof by any Governmental Authority charged with the
enforcement, interpretation or administration thereof, and all applicable administrative orders, directed duties, requests, licenses, authorizations and permits of, and agreements with, any Governmental Authority (in each case whether or not having
the force of law) and (b)&nbsp;all Healthcare Laws; in each case applicable to or binding upon such Person or any of its property or to which such Person or any of its property is subject. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Responsible Officer</U>&#148; shall mean, for any Credit Party, any duly authorized officer or authorized signatory thereof and as to
whom the Administrative Agent has received an incumbency certificate that has not been terminated or revoked indicating such officer or authorized signatory is a duly authorized officer thereof. </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">25 </P>

</DIV></Center>


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


<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">&#147;<U>Restricted Payment</U>&#148; shall mean (a)&nbsp;any dividend or other
distribution, direct or indirect, on account of any shares (or equivalent) of any class of Equity Interest of any Credit Party or any of its Subsidiaries, now or hereafter outstanding, (b)&nbsp;any redemption, retirement, sinking fund or similar
payment, purchase or other acquisition for value, direct or indirect, of any shares (or equivalent) of any class of Equity Interest of any Credit Party or any of its Subsidiaries, now or hereafter outstanding, (c)&nbsp;any payment made to retire, or
to obtain the surrender of, any outstanding warrants, options or other rights to acquire shares of any class of Equity Interest of any Credit Party or any of its Subsidiaries, now or hereafter outstanding, (d)&nbsp;any payment with respect to any
earnout obligation, (e)&nbsp;any payment or prepayment of principal of, premium, if any, or interest on, redemption, purchase, retirement, defeasance, sinking fund or similar payment with respect to, any Subordinated Debt of any Credit Party or any
of its Subsidiaries, (f)&nbsp;the payment by any Credit Party or any of its Subsidiaries of any management, advisory or consulting fee to any Person (other than such fees incurred in the ordinary course of business) or (g)&nbsp;the payment of any
extraordinary salary, bonus or other form of compensation for services to any Person who is directly or indirectly a significant partner, shareholder, owner or executive officer of any such Person, to the extent such extraordinary salary, bonus or
other form of compensation is not or would not be an expense reflected on such Person&#146;s financial statements in accordance with GAAP. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Restrictive Agreement</U>&#148; shall have the meaning set forth in Section&nbsp;9.23(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Revolving Commitment</U>&#148; shall mean, with respect to each Revolving Lender, the commitment of such Revolving Lender to make
Revolving Loans in an aggregate principal amount at any time outstanding up to an amount equal to such Revolving Lender&#146;s Revolving Commitment Percentage of the Revolving Committed Amount. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Revolving Commitment Percentage</U>&#148; shall mean for each Revolving Lender, the percentage identified as its Revolving Commitment
Percentage on Schedule 2.1(a) or in the Assignment and Assumption pursuant to which such Revolving Lender became a Revolving Lender hereunder, as such percentage may be modified after the Closing Date in accordance with the provisions of this Credit
Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Revolving Committed Amount</U>&#148; shall have the meaning set forth in Section&nbsp;2.1(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Revolving Facility</U>&#148; shall have the meaning set forth in Section&nbsp;2.1(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Revolving Lender</U>&#148; shall mean, as of any date of determination, a Lender holding a Revolving Commitment, a Revolving Loan or
a Participation Interest on such date. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Revolving Loans</U>&#148; shall have the meaning set forth in Section&nbsp;2.1(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Revolving Note</U>&#148; or &#147;<U>Revolving Notes</U>&#148; shall mean the promissory notes of the Borrower provided pursuant to
Section&nbsp;2.1(e) in favor of any of the Revolving Lenders evidencing the Revolving Loan provided by any such Revolving Lender pursuant to Section&nbsp;2.1(a), individually or collectively, as appropriate, as such promissory notes may be amended,
modified, extended, restated, replaced, or supplemented from time to time. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>S&amp;P</U>&#148; shall mean Standard&nbsp;&amp;
Poor&#146;s Ratings Services, a division of The McGraw Hill Companies, Inc. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Sale and Leaseback Transaction</U>&#148; shall mean
any arrangement pursuant to which any Credit Party or Subsidiary, directly or indirectly, becomes liable as lessee, guarantor or other surety with respect to any lease, whether an Operating Lease or a Capital Lease, of any property or assets
(a)&nbsp;which a Credit Party or Subsidiary has sold or transferred (or is to sell or transfer) to a Person which is not a Credit Party or Subsidiary or (b)&nbsp;which such Credit Party or Subsidiary intends to use for substantially the same purpose
as any other property or assets which have been sold or transferred (or is to be sold or transferred) by a Credit Party or Subsidiary to another Person which is not a Credit Party or Subsidiary in connection with such lease. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Sanctioned Country</U>&#148; means, at any time, a country, region or territory which is itself the subject or target of any
Sanctions (at the time of this Agreement, Cuba, Iran, North Korea, Sudan, Syria and Crimea). </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">26 </P>

</DIV></Center>


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


<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">&#147;<U>Sanctioned Person</U>&#148; means, at any time, (a)&nbsp;any Person listed in any
Sanctions-related list of designated Persons maintained by the Office of Foreign Assets Control of the U.S. Department of the Treasury, the U.S. Department of State, or by the United Nations Security Council, the European Union or any EU member
state, (b)&nbsp;any Person operating, organized or resident in a Sanctioned Country or (c)&nbsp;any Person owned or controlled by any such Person or Persons. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Sanctions</U>&#148; means economic or financial sanctions or trade embargoes imposed, administered or enforced from time to time by
(a)&nbsp;the U.S. government, including those administered by the Office of Foreign Assets Control of the U.S. Department of the Treasury or the U.S. Department of State, (b)&nbsp;the government of Canada or (c)&nbsp;the United Nations Security
Council, the European Union or Her Majesty&#146;s Treasury of the United Kingdom </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Sarbanes-Oxley</U>&#148; shall mean the <FONT
STYLE="white-space:nowrap">Sarbanes-Oxley</FONT> Act of 2002. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>SEC</U>&#148; shall mean the Securities and Exchange Commission or
any successor Governmental Authority. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Securities Act</U>&#148; shall mean the Securities Act of 1933, together with any
amendment thereto or replacement thereof and any rules or regulations promulgated thereunder. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Securities Laws</U>&#148; shall
mean the Securities Act, the Exchange Act, Sarbanes-Oxley and the applicable accounting and auditing principles, rules, standards and practices promulgated, approved or incorporated by the SEC or the Public Company Accounting Oversight Board, as
each of the foregoing may be amended and in effect on any applicable date hereunder. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Security Documents</U>&#148; shall mean the
Collateral Agreement and each of the security agreements, pledge agreements and other instruments and documents executed and delivered pursuant to the occurrence of the Collateral Event or pursuant to Section&nbsp;5.13. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Single Employer Plan</U>&#148; shall mean any Plan that is not a Multiemployer Plan. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Subordinated Debt</U>&#148; shall mean any Indebtedness incurred by any Credit Party which by its terms is specifically subordinated
in right of payment to the prior payment of the Credit Party Obligations and contains subordination and other terms acceptable to the Administrative Agent. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Subsidiary</U>&#148; shall mean, as to any Person, a corporation, partnership, limited liability company or other entity of which
shares of stock or other ownership interests having ordinary voting power (other than stock or such other ownership interests having such power only by reason of the happening of a contingency) to elect a majority of the board of directors or other
managers of such corporation, limited liability company, partnership or other entity are at the time owned, or the management of which is otherwise controlled, directly or indirectly through one or more intermediaries, or both, by such Person;
<U>provided</U>, that notwithstanding the foregoing, each Practice and each of its Subsidiaries shall constitute a Subsidiary of the Borrower for the purposes of the Credit Documents. Unless otherwise qualified, all references to a
&#147;Subsidiary&#148; or to &#147;Subsidiaries&#148; in this Agreement shall refer to a Subsidiary or Subsidiaries of the Borrower. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Successor Issuing Lender</U>&#148;<U> shall have the meaning set forth in Section</U><U></U><U>&nbsp;2.3(f).</U> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Successor Issuing Lender Agreement</U>&#148;<U> shall have the meaning set forth in Section</U><U></U><U>&nbsp;2.3(f).</U> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Swap Termination Value</U>&#148; shall mean, in respect of any one or more Hedging Agreements, after taking into account the effect
of any legally enforceable netting agreement relating to such Hedging Agreements, (a)&nbsp;for any date on or after the date such Hedging Agreements have been closed out and termination value(s) determined in accordance therewith, such termination
value(s), and (b)&nbsp;for any date prior to the date referenced in clause (a), the amount(s) determined as the <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">mark-to-market</FONT></FONT> value(s) for such Hedging Agreements, as
determined based upon one or more <FONT STYLE="white-space:nowrap">mid-market</FONT> or other readily available quotations provided by any recognized dealer in such Hedging Agreements (which may include a Lender or any Affiliate of a Lender). </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">27 </P>

</DIV></Center>


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


<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">&#147;<U>Target</U>&#148; shall have the meaning set forth in the definition of
&#147;Permitted Acquisition.&#148; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Taxes</U>&#148; shall mean all present or future taxes, levies, imposts, duties, deductions,
withholdings, assessments, fees and other like charges imposed by any Governmental Authority, including any interest, additions to tax or penalties applicable thereto. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Trademark License</U>&#148; shall mean any agreement, whether written or oral, providing for the grant by or to a Person of any right
to use any Trademark. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Trademarks</U>&#148; shall mean (a)&nbsp;all trademarks, trade names, corporate names, company names,
business names, fictitious business names, service marks, elements of package or trade dress of goods or services, logos and other source or business identifiers, together with the goodwill associated therewith, all registrations and recordings
thereof, and all applications in connection therewith, whether in the United States Patent and Trademark Office or in any similar office or agency of the United States, any State thereof or any other country or any political subdivision thereof and
(b)&nbsp;all renewals thereof. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Transactions</U>&#148; shall mean the closing of this Agreement and the other Credit Documents
and the other transactions contemplated hereby to occur in connection with such closing (including, without limitation, the initial borrowings under the Credit Documents and the payment of fees and expenses in connection with all of the foregoing).
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Transfer Effective Date</U>&#148; shall have the meaning set forth in each Assignment and Assumption. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Type</U>&#148; shall mean, as to any Loan, its nature as an Alternate Base Rate Loan or LIBOR Rate Loan, as the case may be. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>UCC</U>&#148; shall mean the Uniform Commercial Code from time to time in effect in any applicable jurisdiction. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>United States</U>&#148; shall mean the United States of America and the states, territories and possessions thereof, including,
without limitation, Puerto Rico. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Unused Commitment Fee</U>&#148; shall have the meaning set forth in Section&nbsp;2.5(a). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>U.S. Lender</U>&#148; shall mean any Lender that is a &#147;United States person&#148; as defined in Section&nbsp;7701(a)(30) of the
Code. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Voting Stock</U>&#148; shall mean, with respect to any Person, Equity Interest issued by such Person the holders of which
are ordinarily, in the absence of contingencies, entitled to vote for the election of directors (or persons performing similar functions) of such Person, even though the right so to vote may be or have been suspended by the happening of such a
contingency. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Works</U>&#148; shall mean all works which are subject to copyright protection pursuant to Title&nbsp;17 of the
United States Code. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">&#147;<U>Write-Down and Conversion Powers</U>&#148; means, with respect to any EEA Resolution Authority, the
write-down and conversion powers of such EEA Resolution Authority from time to time under the <FONT STYLE="white-space:nowrap">Bail-In</FONT> Legislation for the applicable EEA Member Country, which write-down and conversion powers are described in
the EU <FONT STYLE="white-space:nowrap">Bail-In</FONT> Legislation Schedule. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;1.2</B> <B><U>Other
Definitional Provisions</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The definitions of terms herein shall apply equally to the singular and plural forms of the terms
defined. Whenever the context may require, any pronoun shall include the corresponding masculine, feminine and neuter forms. The words &#147;include,&#148; &#147;includes&#148; and &#147;including&#148; shall be deemed to be followed by the phrase
&#147;without limitation.&#148; The word &#147;will&#148; shall be construed to have the same meaning and effect as the word &#147;shall.&#148; Unless the </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">28 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
context requires otherwise (a)&nbsp;any definition of or reference to any agreement, instrument or other document herein shall be construed as referring to such agreement, instrument or other
document as from time to time amended, restated, supplemented, amended and restated or otherwise modified (subject to any restrictions on such amendments, supplements or modifications set forth herein), (b)&nbsp;any reference herein to any Person
shall be construed to include such Person&#146;s successors and assigns, (c)&nbsp;the words &#147;herein,&#148; &#147;hereof&#148; and &#147;hereunder,&#148; and words of similar import, shall be construed to refer to this Agreement in its entirety
and not to any particular provision hereof of this Agreement, (d)&nbsp;all references herein to Articles, Sections, Exhibits and Schedules shall be construed to refer to Articles and Sections of, and Exhibits and Schedules to, this Agreement,
(e)&nbsp;any reference to any law or regulation herein shall, unless otherwise specified, refer to such law or regulation as amended, modified or supplemented from time to time, (f)&nbsp;the words &#147;asset&#148; and &#147;property&#148; shall be
construed to have the same meaning and effect and to refer to any and all tangible and intangible assets and properties, including cash, securities, accounts and contract rights and (g)&nbsp;all terms defined in this Agreement shall have the defined
meanings when used in any other Credit Document or any certificate or other document made or delivered pursuant hereto. The phrase, &#147;to the actual knowledge,&#148; &#147;to the best knowledge,&#148; &#147;to the knowledge&#148; or similar uses
of &#147;knowledge&#148; of a Responsible Officer of the Borrower or other specified Credit Party with respect to any statement made herein means that no information that would give such Responsible Officer current actual knowledge of the inaccuracy
of such statement has come to the attention of such Responsible Officer, nor, except as otherwise expressly indicated, that such Responsible Officer has undertaken any independent investigation to determine the accuracy of such statement other than
due inquiry of other executive employees of such Credit Party who have management responsibilities with respect to the subject matter of such statement in the ordinary course of such employees&#146; duties. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;1.3</B> <B><U>Accounting Terms</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Unless otherwise specified herein, all accounting terms used herein shall be interpreted, all accounting determinations hereunder shall be
made, and all financial statements required to be delivered hereunder shall be prepared in accordance with GAAP applied on a basis consistent with the most recent audited Consolidated financial statements of the Borrower<B> </B>delivered to the
Lenders. If at any time any change in GAAP would affect the computation of any financial ratio or requirement set forth in any Credit Document, and either the Borrower or the Required Lenders shall so request, the Administrative Agent, the Lenders
and the Borrower shall negotiate in good faith to amend such ratio or requirement to preserve the original intent thereof in light of such change in GAAP (subject to the approval of the Required Lenders); provided, that, until so amended,
(a)&nbsp;such ratio or requirement shall continue to be computed in accordance with GAAP prior to such change therein and (b)&nbsp;the Borrower shall provide to the Administrative Agent and the Lenders financial statements and other documents
required under this Agreement or as reasonably requested hereunder setting forth a reconciliation between calculations of such ratio or requirement made before and after giving effect to such change in GAAP. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Borrower shall deliver to the Administrative Agent and each Lender at the same time as the delivery of any annual or quarterly financial
statements given in accordance with the provisions of Section&nbsp;5.1, (a)&nbsp;a description in reasonable detail of any material change in the application of accounting principles employed in the preparation of such financial statements from
those applied in the most recently preceding quarterly or annual financial statements as to which no objection shall have been made in accordance with the provisions above and (b)&nbsp;a reasonable estimate of the effect on the financial statements
on account of such changes in application. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;1.4</B> <B><U>Time References</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Unless otherwise specified, all references herein to times of day shall be references to Eastern time (daylight or standard, as applicable).
</P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;1.5</B> <B><U>Execution of Documents</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Unless otherwise specified, all Credit Documents and all other certificates executed in connection therewith must be signed by a Responsible
Officer. </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">29 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;1.6</B> <B><U>Letter of Credit Amounts</U></B>. Unless
otherwise specified herein, the amount of a Letter of Credit at any time shall be deemed to be the stated amount of such Letter of Credit in effect at such time; provided, however, that with respect to any Letter of Credit that, by its terms or the
terms of any LOC Document related thereto, provides for one or more automatic increases in the stated amount thereof, the amount of such Letter of Credit shall be deemed to be the maximum stated amount of such Letter of Credit after giving effect to
all such increases, whether or not such maximum stated amount is in effect at such time. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B><U STYLE="border-bottom:1pt double; padding-bottom:1pt">Section&nbsp;1.7</U> <U STYLE="border-bottom:1pt double; padding-bottom:1pt">LIBOR
Notification</U> </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">. The interest rate on LIBOR Rate Loans is determined by
reference to the LIBOR Rate, which is derived from the London interbank offered rate. The London interbank offered rate is intended to represent the rate at which contributing banks may obtain short-term borrowings from each other in the London
interbank market. In July 2017, the U.K. Financial Conduct Authority announced that, after the end of 2021, it would no longer persuade or compel contributing banks to make rate submissions to the ICE Benchmark Administration (together with any
successor to the ICE Benchmark Administrator, the &#147;IBA&#148;) for purposes of the IBA setting the London interbank offered rate. As a result, it is possible that commencing in 2022, the London interbank offered rate may no longer be available
or may no longer be deemed an appropriate reference rate upon which to determine the interest rate on LIBOR Rate Loans. In light of this eventuality, public and private sector industry initiatives are currently underway to identify new or
alternative reference rates to be used in place of the London interbank offered rate. In the event that the London interbank offered rate is no longer available or in certain other circumstances as set forth in Section&nbsp;2.13(b) of this
Agreement, such Section&nbsp;2.13(b) provides a mechanism for determining an alternative rate of interest. The Administrative Agent will notify the Borrower, pursuant to Section&nbsp;2.13, in advance of any change to the reference rate upon which
the interest rate on LIBOR Loans is based. However, the Administrative Agent does not warrant or accept any responsibility for, and shall not have any liability with respect to, the administration, submission or any other matter related to the
London interbank offered rate or other rates in the definition of &#147;LIBOR Rate&#148; or with respect to any alternative or successor rate thereto, or replacement rate thereof, including without limitation, whether the composition or
characteristics of any such alternative, successor or replacement reference rate, as it may or may not be adjusted pursuant to Section&nbsp;2.13(b), will be similar to, or produce the same value or economic equivalence of, the LIBOR Rate or have the
same volume or liquidity as did the London interbank offered rate prior to its discontinuance or unavailability.</U> </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE II
</B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>THE LOANS; AMOUNT AND TERMS </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.1</B> <B><U>Revolving Loans</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Revolving Commitment</U>. During the Commitment Period, subject to the terms and conditions hereof, each Revolving Lender severally, but
not jointly, shall make revolving credit loans in Dollars (&#147;<U>Revolving Loans</U>&#148;) to the Borrower from time to time in an aggregate principal amount not at any time exceeding the total of Revolving Commitments of all the Lenders, which
amount on the Closing Date shall equal <B>TWO BILLION DOLLARS ($2,000,000,000) </B>(as increased from time to time as provided in Section&nbsp;2.22 and as such aggregate maximum amount may be reduced from time to time as provided in
Section&nbsp;2.6, the &#147;<U>Revolving Committed Amount</U>&#148;) for the purposes hereinafter set forth (the &#147;<U>Revolving Facility</U>&#148;); <U>provided</U>, <U>however</U>, that (i)&nbsp;with regard to each Revolving Lender
individually, the sum of such Revolving Lender&#146;s Revolving Commitment Percentage of the aggregate principal amount of outstanding Revolving Loans <U>plus</U> such Revolving Lender&#146;s Revolving Commitment Percentage of the outstanding
principal amount of the LOC Obligations shall not exceed such Revolving Lender&#146;s Revolving Commitment and (ii)&nbsp;with regard to the Revolving Lenders collectively, the sum of the aggregate principal amount of outstanding Revolving Loans
<U>plus</U> the aggregate principal amount of outstanding LOC Obligations shall not exceed the Revolving Committed Amount then in effect. Revolving Loans may consist of Alternate Base Rate Loans or LIBOR Rate Loans, or a combination thereof, as the
Borrower may request, and may be repaid and reborrowed in accordance with the provisions hereof; <U>provided</U>, <U>however</U>, the Revolving Loans made on the Closing Date or any of the three (3)&nbsp;Business Days following the Closing Date, may
only consist of Alternate Base Rate Loans unless the Borrower delivers a funding indemnity letter, substantially in the form of <U>Exhibit 2.1(a)</U>, reasonably acceptable to the Administrative Agent on or before the Closing Date, in which case
LIBOR Rate Loans are available to the Borrower. LIBOR Rate Loans shall be made by each Revolving Lender at its LIBOR Lending Office and Alternate Base Rate Loans at its Domestic Lending Office. </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">30 </P>

</DIV></Center>


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


<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">(b) <U>Revolving Loan Borrowings</U>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) <U>Notice of Borrowing</U>. The Borrower shall request a Revolving Loan borrowing by delivering a written Notice of Borrowing (or
telephone notice promptly confirmed in writing by delivery of a written Notice of Borrowing, which delivery may be by fax) to the Administrative Agent not later than 2:00 p.m. on the Business Day of the requested borrowing in the case of Alternate
Base Rate Loans, and on the third Business Day prior to the date of the requested borrowing in the case of LIBOR Rate Loans. Each such Notice of Borrowing shall be irrevocable and shall specify (A)&nbsp;that a Revolving Loan is requested,
(B)&nbsp;the date of the requested borrowing (which shall be a Business Day), (C)&nbsp;the aggregate principal amount to be borrowed and (D)&nbsp;whether the borrowing shall be comprised of Alternate Base Rate Loans, LIBOR Rate Loans or a
combination thereof, and if LIBOR Rate Loans are requested, the Interest Period(s) therefor. If the Borrower shall fail to specify in any such Notice of Borrowing (1)&nbsp;an applicable Interest Period in the case of a LIBOR Rate Loan, then such
notice shall be deemed to be a request for an Interest Period of one month, or (2)&nbsp;the Type of Revolving Loan requested, then such notice shall be deemed to be a request for an Alternate Base Rate Loan hereunder. The Administrative Agent shall
give notice to each Revolving Lender promptly upon receipt of each Notice of Borrowing, the contents thereof and each such Revolving Lender&#146;s share thereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) <U>Minimum Amounts</U>. Each Revolving Loan that is made as an Alternate Base Rate Loan shall be in a minimum aggregate amount of
$1,000,000 and in integral multiples of $500,000 in excess thereof (or the remaining amount of the Revolving Committed Amount, if less). Each Revolving Loan that is made as a LIBOR Rate Loan shall be in a minimum aggregate amount of $1,000,000 and
in integral multiples of $500,000 in excess thereof (or the remaining amount of the Revolving Committed Amount, if less). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii)
<U>Advances</U>. Each Revolving Lender will make its Revolving Commitment Percentage of each Revolving Loan borrowing available to the Administrative Agent for the account of the Borrower at the office of the Administrative Agent specified in
Section&nbsp;9.2, or at such other office as the Administrative Agent may designate in writing, by 1:00 P.M. (or in the case of a borrowing of Alternative Base Rate Loans by 3:00 P.M.) on the date specified in the applicable Notice of Borrowing, in
Dollars and in funds immediately available to the Administrative Agent. Such borrowing will then be made available to the Borrower by the Administrative Agent by crediting the account of the Borrower on the books of such office (or such other
account that the Borrower may designate in writing to the Administrative Agent) with the aggregate of the amounts made available to the Administrative Agent by the Revolving Lenders and in like funds as received by the Administrative Agent. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Repayment</U>. Subject to the terms of this Agreement, Revolving Loans may be borrowed, repaid and reborrowed during the Commitment
Period. The principal amount of all Revolving Loans shall be due and payable in full on the Maturity Date, unless accelerated sooner pursuant to Section&nbsp;7.2. The Borrower shall have the right to repay Revolving Loans in whole or in part from
time to time in accordance with Section&nbsp;2.7. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) <U>Interest</U>. Subject to the provisions of Section&nbsp;2.8, Revolving Loans
shall bear interest as follows: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) <U>Alternate Base Rate Loans</U>. During such periods as any Revolving Loans shall be
composed of Alternate Base Rate Loans, each such Alternate Base Rate Loan shall bear interest at a per annum rate equal to the sum of the Alternate Base Rate <U>plus</U> the Applicable Margin; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) <U>LIBOR Rate Loans</U>. During such periods as Revolving Loans shall be composed of LIBOR Rate Loans, each such LIBOR
Rate Loan shall bear interest at a per annum rate equal to the sum of the LIBOR Rate <U>plus</U> the Applicable Margin. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Interest on
Revolving Loans shall be payable in arrears on each Interest Payment Date. </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">31 </P>

</DIV></Center>


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


<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">(e) <U>Revolving Notes; Covenant to Pay</U>. The Borrower&#146;s obligation to pay each
Revolving Lender shall be evidenced by this Agreement and, upon such Revolving Lender&#146;s request, by a duly executed promissory note of the Borrower to such Revolving Lender in substantially the form of <U>Exhibit 2.1(e)</U>. The Borrower
covenants and agrees to pay the Revolving Loans in accordance with the terms of this Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section&nbsp;2.2
[Reserved]. </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.3</B> <B><U>Letter of Credit Subfacility</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Issuance</U>. Subject to the terms and conditions hereof and of the LOC Documents, if any, and any other terms and conditions which the
Issuing Lenders may reasonably require, during the Commitment Period each Issuing Lender shall issue, and the Revolving Lenders shall participate in, Letters of Credit for the account of the Borrower from time to time upon request in a form
acceptable to the applicable Issuing Lender; <U>provided</U>, <U>however</U>, that (i)&nbsp;the aggregate principal amount of LOC Obligations shall not at any time exceed <B>THIRTY-SEVEN MILLION, FIVE HUNDRED THOUSAND DOLLARS ($37,500,000)</B> (the
&#147;<U>LOC Committed Amount</U>&#148;), (ii)&nbsp;the sum of the aggregate principal amount of outstanding Revolving Loans <U>plus</U> the aggregate principal amount of outstanding LOC Obligations shall not at any time exceed the Revolving
Committed Amount then in effect, (iii)&nbsp;no Issuing Lender will be required to issue Letters of Credit in an aggregate amount in excess of such Issuing Lender&#146;s Issuing Lender Sublimit, (iv)&nbsp;all Letters of Credit shall be denominated in
Dollars and (v)&nbsp;Letters of Credit shall be issued for any lawful corporate purposes and may be issued as standby letters of credit, including in connection with workers&#146; compensation and other insurance programs and commercial letters of
credit. Except as otherwise expressly agreed upon by all the Revolving Lenders, no Letter of Credit shall have an original expiry date more than twelve (12)&nbsp;months from the date of issuance; <U>provided</U>, <U>however</U>, so long as no
Default or Event of Default has occurred and is continuing and subject to the other terms and conditions to the issuance of Letters of Credit hereunder, the expiry dates of Letters of Credit may be extended annually or periodically from time to time
on the request of the Borrower or by operation of the terms of the applicable Letter of Credit to a date not more than twelve (12)&nbsp;months from the date of extension; <U>provided</U>, <U>further</U>, that no Letter of Credit, as originally
issued or as extended, shall have an expiry date extending beyond the date that is thirty (30)&nbsp;days prior to the Maturity Date. Each Letter of Credit shall comply with the related LOC Documents. The issuance and expiry date of each Letter of
Credit shall be a Business Day. Each Letter of Credit issued hereunder shall be in a minimum original face amount of $100,000 or such lesser amount as approved by the applicable Issuing Lender. The Borrower&#146;s Reimbursement Obligations in
respect of each Existing Letter of Credit, and each Revolving Lender&#146;s participation obligations in connection therewith, shall be governed by the terms of this Credit Agreement. The Existing Letters of Credit shall, as of the Closing Date, be
deemed to have been issued as Letters of Credit hereunder and subject to and governed by the terms of this Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Notice and
Reports</U>. The request for the issuance of a Letter of Credit shall be submitted to the applicable Issuing Lender at least five (5)&nbsp;Business Days prior to the requested date of issuance. The applicable Issuing Lender will promptly upon
request provide to the Administrative Agent for dissemination to the Revolving Lenders a detailed report specifying the Letters of Credit which are then issued by such Issuing Lender and outstanding and any activity with respect thereto which may
have occurred since the date of any prior report, and including therein, among other things, the account party, the beneficiary, the face amount, expiry date as well as any payments or expirations which may have occurred. Each Issuing Lender will
further provide to the Administrative Agent promptly upon request copies of the Letters of Credit. Each Issuing Lender will provide to the Administrative Agent promptly upon request a summary report of the nature and extent of LOC Obligations then
outstanding. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Participations</U>. Each Revolving Lender, (i)&nbsp;on the Closing Date with respect to each Existing Letter of
Credit and (ii)&nbsp;upon issuance of a Letter of Credit, shall be deemed to have purchased without recourse a risk participation from the applicable Issuing Lender in such Letter of Credit and the obligations arising thereunder, in each case in an
amount equal to its Revolving Commitment Percentage of the obligations under such Letter of Credit and shall absolutely, unconditionally and irrevocably assume, as primary obligor and not as surety, and be obligated to pay to the applicable Issuing
Lender therefor and discharge when due, its Revolving Commitment Percentage of the obligations arising under such Letter of Credit; <U>provided</U> that any Person that becomes a Revolving Lender after the Closing Date shall be deemed to have
purchased a Participation Interest in all outstanding Letters of Credit on the date it becomes a Lender hereunder and any Letter of Credit issued on or after such date, in each case in accordance with the foregoing terms. Without limiting the scope
and nature of each Revolving Lender&#146;s </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">32 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
participation in any Letter of Credit, to the extent that the applicable Issuing Lender has not been reimbursed as required hereunder or under any LOC Document, each such Revolving Lender shall
pay to such Issuing Lender its Revolving Commitment Percentage of such unreimbursed drawing in same day funds pursuant to and in accordance with the provisions of subsection (d)&nbsp;hereof. The obligation of each Revolving Lender to so reimburse
the Issuing Lenders shall be absolute and unconditional and shall not be affected by the occurrence of a Default, an Event of Default or any other occurrence or event. Any such reimbursement shall not relieve or otherwise impair the obligation of
the Borrower to reimburse the Issuing Lenders under any Letter of Credit, together with interest as hereinafter provided. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d)
<U>Reimbursement</U>. In the event of any drawing under any Letter of Credit, the applicable Issuing Lender will promptly notify the Borrower and the Administrative Agent. The Borrower shall reimburse the applicable Issuing Lender on the day of
drawing under any Letter of Credit if notified prior to 3:00 P.M. on a Business Day or, if after 3:00 P.M., on the following Business Day (either with the proceeds of a Revolving Loan obtained hereunder or otherwise) in same day funds as provided
herein or in the LOC Documents. If the Borrower shall fail to reimburse the Issuing Lenders as provided herein, the unreimbursed amount of such drawing shall bear interest at a per annum rate equal to the Default Rate. Unless the Borrower shall
immediately notify the applicable Issuing Lender and the Administrative Agent of its intent to otherwise reimburse such Issuing Lender, the Borrower shall be deemed to have requested a Mandatory LOC Borrowing (as defined in Section&nbsp;2.3(e)) in
the amount of the drawing as provided in subsection (e)&nbsp;hereof, the proceeds of which will be used to satisfy the Reimbursement Obligations. The Borrower&#146;s Reimbursement Obligations hereunder shall be absolute and unconditional under all
circumstances irrespective of any rights of <FONT STYLE="white-space:nowrap">set-off,</FONT> counterclaim or defense to payment the Borrower may claim or have against the Issuing Lenders, the Administrative Agent, the Lenders, the beneficiary of the
Letter of Credit drawn upon or any other Person, including, without limitation, any defense based on any failure of the Borrower to receive consideration or the legality, validity, regularity or unenforceability of the Letter of Credit. Each Issuing
Lender will promptly notify the other Revolving Lenders of the amount of any unreimbursed drawing and each Revolving Lender shall promptly pay to the Administrative Agent for the account of such Issuing Lender, in Dollars and in immediately
available funds, the amount of such Revolving Lender&#146;s Revolving Commitment Percentage of such unreimbursed drawing. Such payment shall be made on the Business Day such notice is received by such Revolving Lender from the applicable Issuing
Lender if such notice is received at or before 2:00 P.M., otherwise such payment shall be made at or before noon on the Business Day next succeeding the Business Day such notice is received. If such Revolving Lender does not pay such amount to the
applicable Issuing Lender in full upon such request, such Revolving Lender shall, on demand, pay to the Administrative Agent for the account of such Issuing Lender interest on the unpaid amount during the period from the date of such drawing until
such Revolving Lender pays such amount to such Issuing Lender in full at a rate per annum equal to, if paid within two (2)&nbsp;Business Days of the date of drawing, the Federal Funds Effective Rate and thereafter at a rate equal to the Alternate
Base Rate. Each Revolving Lender&#146;s obligation to make such payment to the Issuing Lenders, and the right of the Issuing Lenders to receive the same, shall be absolute and unconditional, shall not be affected by any circumstance whatsoever and
without regard to the termination of this Agreement or the Commitments hereunder, the existence of a Default or Event of Default or the acceleration of the Obligations hereunder and shall be made without any offset, abatement, withholding or
reduction whatsoever. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) <U>Repayment with Revolving Loans</U>. On any day on which the Borrower shall have requested, or been deemed to
have requested, a Revolving Loan to reimburse a drawing under a Letter of Credit, the Administrative Agent shall give notice to the Revolving Lenders that a Revolving Loan has been requested or deemed requested in connection with a drawing under a
Letter of Credit, in which case a Revolving Loan borrowing comprised entirely of Alternate Base Rate Loans (each such borrowing, a &#147;<U>Mandatory LOC Borrowing</U>&#148;) shall be made (without giving effect to any termination of the Commitments
pursuant to Section&nbsp;7.2) pro rata based on each Revolving Lender&#146;s respective Revolving Commitment Percentage (determined before giving effect to any termination of the Commitments pursuant to Section&nbsp;7.2) and the proceeds thereof
shall be paid directly to the applicable Issuing Lender for application to the respective LOC Obligations. Each Revolving Lender hereby irrevocably agrees to make such Revolving Loans on the day such notice is received by the Revolving Lenders from
the Administrative Agent if such notice is received at or before 2:00 P.M., otherwise such payment shall be made at or before noon on the Business Day next succeeding the day such notice is received, in each case <U>notwithstanding</U> (i)&nbsp;the
amount of Mandatory LOC Borrowing may not comply with the minimum amount for borrowings of Revolving Loans otherwise required hereunder, (ii)&nbsp;whether any conditions specified in Section&nbsp;4.2 are then satisfied, (iii)&nbsp;whether a Default
or an Event of Default then exists, (iv)&nbsp;failure for any such request or deemed </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">33 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
request for Revolving Loan to be made by the time otherwise required in Section&nbsp;2.1(b), (v)&nbsp;the date of such Mandatory LOC Borrowing, or (vi)&nbsp;any reduction in the Revolving
Committed Amount after any such Letter of Credit may have been drawn upon. In the event that any Mandatory LOC Borrowing cannot for any reason be made on the date otherwise required above (including, without limitation, as a result of the occurrence
of a Bankruptcy Event), then each such Revolving Lender hereby agrees that it shall forthwith fund its Participation Interests in the outstanding LOC Obligations on the Business Day such notice to fund is received by such Revolving Lender from the
Administrative Agent if such notice is received at or before 2:00&nbsp;P.M., otherwise such payment shall be made at or before 12:00&nbsp;Noon on the Business Day next succeeding the Business Day such notice is received; <U>provided</U>,
<U>further</U>, that in the event any Revolving Lender shall fail to fund its Participation Interest as required herein, then the amount of such Revolving Lender&#146;s unfunded Participation Interest therein shall automatically bear interest
payable by such Revolving Lender to the Administrative Agent for the account of the Issuing Lenders upon demand, at the rate equal to, if paid within two (2)&nbsp;Business Days of such date, the Federal Funds Effective Rate, and thereafter at a rate
equal to the Alternate Base Rate. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) <U>Modification, Extension</U>. The issuance of any supplement, modification, amendment, renewal,
or extension to any Letter of Credit shall, for purposes hereof, be treated in all respects the same as the issuance of a new Letter of Credit hereunder. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(g) <U>ISP98 and UCP</U>. Unless otherwise expressly agreed by the applicable Issuing Lender and the Borrower, when a Letter of Credit is
issued, (i)&nbsp;the rules of the &#147;International Standby Practices 1998,&#148; published by the Institute of International Banking Law&nbsp;&amp; Practice (or such later version thereof as may be in effect at the time of issuance) shall apply
to each standby Letter of Credit, and (ii)&nbsp;the rules of The Uniform Customs and Practice for Documentary Credits, as most recently published by the International Chamber of Commerce at the time of issuance, shall apply to each commercial Letter
of Credit. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(h) <U>Conflict with LOC Documents</U>. In the event of any conflict between this Agreement and any LOC Document (including
any letter of credit application and any LOC Documents relating to the Existing Letters of Credit), this Agreement shall control. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i)
<U>Designation of Subsidiaries as Account Parties</U>. Notwithstanding anything to the contrary set forth in this Agreement, including, without limitation, Section&nbsp;2.3(a), a Letter of Credit issued hereunder may contain a statement to the
effect that such Letter of Credit is issued for the account of a Subsidiary of the Borrower; <U>provided</U> that, notwithstanding such statement, the Borrower shall be the actual account party for all purposes of this Agreement for such Letter of
Credit and such statement shall not affect the Borrower&#146;s Reimbursement Obligations hereunder with respect to such Letter of Credit. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(j) <U>Cash Collateral</U>. At any point in time in which there is a Defaulting Lender, the Issuing Lenders may require the Borrower to Cash
Collateralize the LOC Obligations pursuant to Section&nbsp;2.20. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(k) <U>Resignation of Issuing Lender</U>. An Issuing Lender may resign
by giving 30 days&#146; prior written notice to each of the Administrative Agent, the Borrower and the Revolving Lenders in the event that such Person and its Affiliates no longer hold any Revolving Commitments; provided that no such resignation
shall be effective if there shall not be one or more other Issuing Lender (or Revolving Lenders willing to become an Issuing Lender) (each, a &#147;<U>Successor Issuing Lender</U>&#148;) at such time that will provide a LOC Commitment (or in the
case of existing Issuing Lenders, that will increase its LOC Commitment) in an amount not less than such resigning Issuing Lender&#146;s Issuing Lender Sublimit. Notwithstanding the foregoing, no such resignation shall be effective if it results
(after giving effect to the proviso of the immediately preceding sentence) in a decrease in the LOC Committed Amount then in effect. The acceptance of any appointment as an Issuing Lender hereunder by a Successor Issuing Lender shall be evidenced by
an agreement entered into by such resigning Issuing Lender and Successor Issuing Lender, in a form satisfactory to the Borrower and the Administrative Agent (each, a &#147;<U>Successor Issuing Lender Agreement</U>&#148;). Upon the acceptance of any
appointment as an Issuing Lender hereunder and the effectiveness of the applicable Successor Issuing Lender Agreement, (i)&nbsp;such Successor Issuing Lender shall succeed to and become vested with all of the rights, powers, privileges and duties of
the resigning Issuing Lender in in its capacity as a resigning Issuing Lender, (ii)&nbsp;such resigning Issuing Lender shall be discharged from all of its respective duties and obligations hereunder or under the other Credit Documents, and
(iii)&nbsp;the Successor Issuing Lender shall issue letters of credit in substitution for the Letters of Credit, if any, outstanding at the time of such succession or make other </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">34 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
arrangements satisfactory to the resigning Issuing Lender and the Borrower to effectively assume the obligations of such resigning Issuing Lender with respect to such Letters of Credit. Such
resignation shall not affect the validity or effectiveness of any Letter of Credit issued prior to such resignation by the resigning Issuing Lender. At the time such resignation of an Issuing Bank shall become effective, the Borrower shall pay all
accrued and unpaid Letter of Credit Facing Fees to such resigning Issuing Bank. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.4</B> <B>[Reserved]</B>.
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.5</B> <B><U>Fees</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Unused Commitment Fee</U>. Subject to Section&nbsp;2.21, in consideration of the Revolving Commitments, the Borrower agrees to pay to
the Administrative Agent, for the ratable benefit of the Revolving Lenders, a commitment fee (the &#147;<U>Unused Commitment Fee</U>&#148;) at an annual rate equal to the Applicable Margin multiplied by the average daily unused amount of the
Revolving Committed Amount. For purposes of computation of the Unused Commitment Fee, LOC Obligations shall be considered usage of the Revolving Committed Amount. The Unused Commitment Fee shall be calculated by the Administrative Agent and shall be
payable by the Borrower quarterly in arrears on the last Business Day of each calendar quarter. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Letter of Credit Fees</U>. Subject
to Section&nbsp;2.21, in consideration of the LOC Commitments, the Borrower agrees to pay to the Administrative Agent, for the ratable benefit of the Revolving Lenders, a fee (the &#147;<U>Letter of Credit Fee</U>&#148;) equal to the Applicable
Margin for Revolving Loans that are LIBOR Rate Loans per annum on the average daily maximum amount available to be drawn under each Letter of Credit from the date of issuance to the date of expiration. The Letter of Credit Fee shall be calculated by
the Administrative Agent and shall be payable by the Borrower quarterly in arrears on the last Business Day of each calendar quarter. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c)
<U>Issuing Lender Fees</U>. In addition to the Letter of Credit Fees payable pursuant to subsection (b)&nbsp;hereof, the Borrower shall pay to each Issuing Lender for its own account without sharing by the other Lenders the reasonable and customary
charges from time to time of such Issuing Lender with respect to the amendment, transfer, administration, cancellation and conversion of, and drawings under, the Letters of Credit issued by such Issuing Lender (collectively, the &#147;<U>Issuing
Lender Fees</U>&#148;). Each Issuing Lender may charge, and retain for its own account without sharing by the other Lenders, an additional facing fee (the &#147;<U>Letter of Credit Facing Fee</U>&#148;) of 0.125% per annum on the average daily
maximum amount available to be drawn under each such Letter of Credit issued by it. The Issuing Lender Fees and the Letter of Credit Facing Fee shall be calculated by the Administrative Agent and shall be payable by the Borrower quarterly in arrears
on the last Business Day of each calendar quarter. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) <U>Administrative Fee</U>. The Borrower agrees to pay to the Administrative Agent
the annual administrative fee as described in its Fee Letter. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.6</B> <B><U>Revolving Commitment
Reductions</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Voluntary Reductions</U>. The Borrower shall have the right to terminate or permanently reduce the unused
portion of the Revolving Committed Amount at any time or from time to time subject to Section&nbsp;2.15 but otherwise without premium or penalty upon not less than five (5)&nbsp;Business Days&#146; prior written notice to the Administrative Agent
(which shall notify the Lenders thereof as soon as practicable) of each such termination or reduction, which notice shall specify the effective date thereof and the amount of any such reduction which shall be in a minimum amount of $1,000,000 or a
whole multiple of $500,000 in excess thereof and shall be irrevocable and effective upon receipt by the Administrative Agent; <U>provided</U> that no such reduction or termination shall be permitted if after giving effect thereto, and to any
prepayments of the Revolving Loans made on the effective date thereof, the sum of the aggregate principal amount of outstanding Revolving Loans <U>plus</U> the aggregate principal amount of outstanding LOC Obligations would exceed&nbsp;the Revolving
Committed Amount then in effect; <U>provided</U>, further that such notice may be conditioned upon the effectiveness of other credit facilities or the consummation of a transaction, the proceeds of which shall be used to repay the Obligations in
connection with any such termination, in which case such notice may be revoked by the Borrower (by notice to the Administrative Agent on or prior to the specified effective date) if such condition or conditions are not satisfied. </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">35 </P>

</DIV></Center>


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


<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">(b) <U>LOC Committed Amount</U>. If the Revolving Committed Amount is reduced below the then
current LOC Committed Amount, the LOC Committed Amount shall automatically be reduced by an amount such that the LOC Committed Amount equals the Revolving Committed Amount. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Maturity Date</U>. The Revolving Commitments and the LOC Commitment shall automatically terminate on the Maturity Date. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.7</B> <B><U>Repayments</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Optional Repayments</U>. The Borrower shall have the right to repay<B> </B>Loans in whole or in part from time to time; <U>provided</U>,
<U>however</U>, that each partial repayment of (i)&nbsp;Alternate Base Rate Loans shall be in a minimum principal amount of $1,000,000 and integral multiples of $500,000 in excess thereof (or the remaining outstanding principal amount),
(ii)&nbsp;LIBOR Rate Loans shall be in a minimum principal amount of $1,000,000 and integral multiples of $500,000 in excess thereof (or the remaining outstanding principal amount). The Borrower shall give three (3)&nbsp;Business Days&#146;
irrevocable notice of repayment in the case of LIBOR Rate Loans and <FONT STYLE="white-space:nowrap">same-day</FONT> irrevocable notice on any Business Day in the case of Alternate Base Rate Loans, to the Administrative Agent (which shall notify the
applicable Lenders thereof as soon as practicable); provided, that such notice may be conditioned upon the effectiveness of other credit facilities or the consummation of a transaction, the proceeds of which shall be used to repay the Loans in full
or in part, in which case such notice may be revoked by the Borrower (by notice to the Administrative Agent on or prior to the specified effective date) if such condition or conditions are not satisfied. Within the foregoing parameters, repayments
under this Section shall be applied first to Alternate Base Rate Loans and then to LIBOR Rate Loans in direct order of Interest Period maturities. All repayments under this Section shall be subject to Section&nbsp;2.15, but otherwise without premium
or penalty. Interest on the principal amount repaid shall be payable on the next occurring Interest Payment Date that would have occurred had such loan not been repaid or, at the request of the Administrative Agent, interest on the principal amount
repaid shall be payable on any date that a repayment is made hereunder through the date of repayment. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Mandatory Repayments</U>.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) <U>Revolving Committed Amount</U>. If at any time after the Closing Date, the sum of the aggregate principal amount of outstanding
Revolving Loans <U>plus</U> the aggregate principal amount of outstanding LOC Obligations shall exceed the Revolving Committed Amount, the Borrower shall immediately repay the Revolving Loans or (after all Revolving Loans have been repaid) Cash
Collateralize the LOC Obligations in an amount sufficient to eliminate such excess (such repayment to be applied as set forth in clause (ii)&nbsp;below) and on terms and conditions reasonably satisfactory to the Administrative Agent. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) <U>Application of Mandatory Repayments</U>. All amounts required to be paid pursuant to this Section shall be applied
(1)<I>&nbsp;first</I> to the outstanding Revolving Loans and (2)<I>&nbsp;second</I> to Cash Collateralize the LOC Obligations. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Within the
parameters of the applications set forth above, repayments shall be applied first to Alternate Base Rate Loans and then to LIBOR Rate Loans in direct order of Interest Period maturities. All repayments under this Section shall be subject to
Section&nbsp;2.15 and be accompanied by interest on the principal amount repaid through the date of repayment, but otherwise without premium or penalty. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Bank Products Unaffected</U>. Any repayment made pursuant to this Section shall not affect the Borrower&#146;s obligation to continue
to make payments under any Bank Product, which shall remain in full force and effect notwithstanding such repayment, subject to the terms of such Bank Product. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.8</B> <B><U>Default Rate and Payment Dates</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) If all or a portion of the principal amount of any Loan which is a LIBOR Rate Loan shall not be paid when due or continued as a LIBOR Rate
Loan in accordance with the provisions of Section&nbsp;2.9 (whether at the stated maturity, by acceleration or otherwise), such overdue principal amount of such Loan shall be converted to an Alternate Base Rate Loan at the end of the Interest Period
applicable thereto. </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">36 </P>

</DIV></Center>


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


<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">(b) Upon the occurrence, and during the continuance, of any Event of Default hereunder, the
principal of and, to the extent permitted by law, interest on the Loans and any other amounts owing hereunder or under the other Credit Documents shall bear interest, payable on demand, at a per annum rate which is equal to the Default Rate. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) Interest on each Loan shall be payable in arrears on each Interest Payment Date; <U>provided</U> that interest accruing pursuant to
paragraph (b)&nbsp;of this Section shall be payable from time to time on demand. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.9</B> <B><U>Conversion
Options</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) The Borrower may elect from time to time to convert Alternate Base Rate Loans to LIBOR Rate Loans or to continue
LIBOR Rate Loans, by delivering a Notice of Conversion/Extension to the Administrative Agent at least three (3)&nbsp;Business Days prior to the proposed date of conversion or continuation. In addition, the Borrower may elect from time to time to
convert all or any portion of a LIBOR Rate Loan to an Alternate Base Rate Loan by giving the Administrative Agent irrevocable written notice thereof by 11:00 A.M. one (1)&nbsp;Business Day prior to the proposed date of conversion. If the date upon
which an Alternate Base Rate Loan is to be converted to a LIBOR Rate Loan is not a Business Day, then such conversion shall be made on the next succeeding Business Day and during the period from such last day of an Interest Period to such succeeding
Business Day such Loan shall bear interest as if it were an Alternate Base Rate Loan. LIBOR Rate Loans may only be converted to Alternate Base Rate Loans on the last day of the applicable Interest Period. If the date upon which a LIBOR Rate Loan is
to be converted to an Alternate Base Rate Loan is not a Business Day, then such conversion shall be made on the next succeeding Business Day and during the period from such last day of an Interest Period to such succeeding Business Day such Loan
shall bear interest as if it were an Alternate Base Rate Loan. All or any part of outstanding Alternate Base Rate Loans may be converted as provided herein; <U>provided</U> that (i)&nbsp;no Loan may be converted into a LIBOR Rate Loan when any
Default or Event of Default has occurred and is continuing and (ii)&nbsp;partial conversions shall be in an aggregate principal amount of $1,000,000 or a whole multiple of $1,000,000 in excess thereof. All or any part of outstanding LIBOR Rate Loans
may be converted as provided herein; <U>provided</U> that partial conversions shall be in an aggregate principal amount of $1,000,000 or a whole multiple of $1,000,000 in excess thereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Any LIBOR Rate Loans may be continued as such upon the expiration of an Interest Period with respect thereto by compliance by the Borrower
with the notice provisions contained in Section&nbsp;2.9(a); <U>provided</U>, that no LIBOR Rate Loan may be continued as such when any Default or Event of Default has occurred and is continuing, in which case such Loan shall be automatically
converted to an Alternate Base Rate Loan at the end of the applicable Interest Period with respect thereto. If the Borrower shall fail to give timely notice of an election to continue a LIBOR Rate Loan, or the continuation of LIBOR Rate Loans is not
permitted hereunder, such LIBOR Rate Loans shall be automatically converted to Alternate Base Rate Loans at the end of the applicable Interest Period with respect thereto. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.10</B> <B><U>Computation of Interest and Fees; Usury</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Interest payable hereunder with respect to any Alternate Base Rate Loan based on the Prime Rate shall be calculated on the basis of a year
of three hundred sixty-five (365)&nbsp;days (or three hundred <FONT STYLE="white-space:nowrap">sixty-six</FONT> (366)&nbsp;days, as applicable) for the actual days elapsed. All other fees, interest and all other amounts payable hereunder shall be
calculated on the basis of a three hundred sixty (360)&nbsp;day year for the actual days elapsed. The Administrative Agent shall as soon as practicable notify the Borrower and the Lenders of each determination of a LIBOR Rate on the Business Day of
the determination thereof. Any change in the interest rate on a Loan resulting from a change in the Alternate Base Rate shall become effective as of the opening of business on the day on which such change in the Alternate Base Rate shall become
effective. The Administrative Agent shall as soon as practicable notify the Borrower and the Lenders of the effective date and the amount of each such change. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Each determination of an interest rate by the Administrative Agent pursuant to any provision of this Agreement shall be conclusive and
binding on the Borrower and the Lenders in the absence of manifest error. The Administrative Agent shall, at the request of the Borrower, deliver to the Borrower a statement showing the computations used by the Administrative Agent in determining
any interest rate. </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">37 </P>

</DIV></Center>


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


<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">(c) It is the intent of the Lenders and the Credit Parties to conform to and contract in
strict compliance with applicable usury law from time to time in effect. All agreements between the Lenders and the Credit Parties are hereby limited by the provisions of this subsection which shall override and control all such agreements, whether
now existing or hereafter arising and whether written or oral. In no way, nor in any event or contingency (including, but not limited to, prepayment or acceleration of the maturity of any Obligation), shall the interest taken, reserved, contracted
for, charged, or received under this Agreement, under the Notes or otherwise, exceed the maximum nonusurious amount permissible under applicable law. If, from any possible construction of any of the Credit Documents or any other document, interest
would otherwise be payable in excess of the maximum nonusurious amount, any such construction shall be subject to the provisions of this paragraph and such interest shall be automatically reduced to the maximum nonusurious amount permitted under
applicable law, without the necessity of execution of any amendment or new document. If any Lender shall ever receive anything of value which is characterized as interest on the Loans under applicable law and which would, apart from this provision,
be in excess of the maximum nonusurious amount, an amount equal to the amount which would have been excessive interest shall, without penalty, be applied to the reduction of the principal amount owing on the Loans and not to the payment of interest,
or refunded to the Borrower or the other payor thereof if and to the extent such amount which would have been excessive exceeds such unpaid principal amount of the Loans. The right to demand payment of the Loans or any other Indebtedness evidenced
by any of the Credit Documents does not include the right to receive any interest which has not otherwise accrued on the date of such demand, and the Lenders do not intend to charge or receive any unearned interest in the event of such demand. All
interest paid or agreed to be paid to the Lenders with respect to the Loans shall, to the extent permitted by applicable law, be amortized, prorated, allocated, and spread throughout the full stated term (including any renewal or extension) of the
Loans so that the amount of interest on account of such Indebtedness does not exceed the maximum nonusurious amount permitted by applicable law. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.11</B> <B><U>Pro Rata Treatment and Payments</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Allocation of Payments Prior to Exercise of Remedies</U>. Each borrowing of Revolving Loans and any reduction of the Revolving
Commitments shall be made pro rata according to the respective Revolving Commitment Percentages of the Revolving Lenders. Unless otherwise required by the terms of this Agreement, each payment under this Agreement or any Note shall be applied,
<U>first</U>, to any fees then due and owing by the Borrower pursuant to Section&nbsp;2.5, <U>second</U>, to interest then due and owing hereunder and under the Notes of the Borrower and, <U>third</U>, to principal then due and owing hereunder and
under the Notes of the Borrower. Each payment on account of any fees pursuant to Section&nbsp;2.5 shall be made pro rata in accordance with the respective amounts due and owing (except as to the Letter of Credit Facing Fees and the Issuing Lender
Fees). Each payment or prepayment by the Borrower on account of principal of and interest on the Revolving Loans shall be applied to such Loans, as applicable, on a pro rata basis. Each mandatory prepayment on account of principal of the Loans as
required by Section&nbsp;2.7(b)(i) shall be applied in accordance with Section&nbsp;2.7(b)(ii). All payments (including prepayments) to be made by the Borrower on account of principal, interest and fees shall be made without defense, <FONT
STYLE="white-space:nowrap">set-off</FONT> or counterclaim (except as provided in Section&nbsp;2.16(b)) and shall be made to the Administrative Agent for the account of the Lenders at the Administrative Agent&#146;s office specified in
Section&nbsp;9.2 in Dollars and in immediately available funds not later than 1:00 P.M. on the date when due. The Administrative Agent shall distribute such payments to the Lenders entitled thereto promptly upon receipt in like funds as received. If
any payment hereunder (other than payments on the LIBOR Rate Loans) becomes due and payable on a day other than a Business Day, such payment shall be extended to the next succeeding Business Day, and, with respect to payments of principal, interest
thereon shall be payable at the then applicable rate during such extension. If any payment on a LIBOR Rate Loan becomes due and payable on a day other than a Business Day, such payment date shall be extended to the next succeeding Business Day
unless the result of such extension would be to extend such payment into another calendar month, in which event such payment shall be made on the immediately preceding Business Day. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Allocation of Payments After Exercise of Remedies</U>. Notwithstanding any other provisions of this Agreement to the contrary, after
the exercise of remedies (other than the invocation of default interest pursuant to Section&nbsp;2.8) by the Administrative Agent or the Lenders pursuant to Section&nbsp;7.2 (or after the Commitments shall automatically terminate and the Loans (with
accrued interest thereon) and all other amounts under the Credit Documents (including, without limitation, the maximum amount of all contingent liabilities under Letters of Credit) shall automatically become due and payable in accordance with the
terms of such Section), all amounts collected or received by the Administrative Agent or any Lender on account of the Credit Party Obligations or any other amounts outstanding under any of the Credit Documents shall be paid over or delivered as
follows (irrespective of whether the following costs, expenses, fees, interest, premiums, scheduled periodic payments or Credit Party Obligations are allowed, permitted or recognized as a claim in any proceeding resulting from the occurrence of a
Bankruptcy Event): </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">FIRST, to the payment of all reasonable
<FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> costs and expenses (including, without limitation, reasonable attorneys&#146; fees) of the Administrative Agent in connection with enforcing the rights of
the Lenders under the Credit Documents; </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">38 </P>

</DIV></Center>


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


<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">SECOND, to the payment of any fees owed to the Administrative Agent and the
Issuing Lenders; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">THIRD, to the payment of all reasonable
<FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> costs and expenses (including, without limitation, reasonable and documented attorneys&#146; fees) of each of the Lenders in connection with enforcing its
rights under the Credit Documents or otherwise with respect to the Credit Party Obligations owing to such Lender to the extent due and payable by any Credit Party pursuant to Section&nbsp;9.5; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">FOURTH, to the payment of all of the Credit Party Obligations consisting of accrued fees and interest, and including, with
respect to any Bank Product, any fees, premiums and scheduled periodic payments due under such Bank Product (other than payments on account of principal) and any interest accrued thereon; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">FIFTH, to the payment of the outstanding principal amount of the Credit Party Obligations and the payment or Cash
Collateralization of the outstanding LOC Obligations, and including with respect to any Bank Product, any breakage, termination or other payments due under such Bank Product; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">SIXTH, to all other Credit Party Obligations and other obligations which shall have become due and payable under the Credit
Documents or otherwise and not repaid pursuant to clauses &#147;FIRST&#148; through &#147;FIFTH&#148; above; and </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">SEVENTH,
to the payment of the surplus, if any, to whoever may be lawfully entitled to receive such surplus. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In carrying out the foregoing,
(a)&nbsp;amounts received shall be applied in the numerical order provided until exhausted prior to application to the next succeeding category; (b)&nbsp;each of the Lenders and any Bank Product Provider shall receive an amount equal to its pro rata
share (based on the proportion that the then outstanding Loans and LOC Obligations held by such Lender or the outstanding obligations payable to such Bank Product Provider bears to the aggregate then outstanding Loans and LOC Obligations and
obligations payable under all Bank Products) of amounts available to be applied pursuant to clauses &#147;THIRD,&#148; &#147;FOURTH,&#148; &#147;FIFTH&#148; and &#147;SIXTH&#148; above; and (c)&nbsp;to the extent that any amounts available for
distribution pursuant to clause &#147;FIFTH&#148; above are attributable to the issued but undrawn amount of outstanding Letters of Credit, such amounts shall be held by the Administrative Agent in a Cash Collateral account and applied
(i)&nbsp;first, to reimburse the applicable Issuing Lenders from time to time for any drawings under such Letters of Credit and (ii)&nbsp;then, following the expiration of all Letters of Credit, to all other obligations of the types described in
clauses &#147;FIFTH&#148; and &#147;SIXTH&#148; above in the manner provided in this Section. Notwithstanding the foregoing terms of this Section, (x)&nbsp;only payments under the Guaranty (as opposed to ordinary course principal, interest and fee
payments hereunder) shall be applied to obligations under any Bank Product and (y)&nbsp;Excluded Swap Obligations with respect to any Guarantor shall not be paid with amounts received from such Guarantor or its assets, but appropriate adjustments
shall be made with respect to payments from other Credit Parties to preserve the allocation to Credit Party Obligations otherwise set forth above in this Section. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.12</B> <B><U><FONT STYLE="white-space:nowrap">Non-Receipt</FONT> of Funds by the Administrative Agent</U></B>.
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Funding by Lenders; Presumption by Administrative Agent</U>. Unless the Administrative Agent shall have received written notice
from a Lender prior to the proposed time of any Extension of Credit that such Lender will not make available to the Administrative Agent such Lender&#146;s share of such Extension of Credit, the Administrative Agent may assume that such Lender has
made such share available on such date in accordance with this Agreement and may, in reliance upon such assumption, make available to the Borrower a corresponding </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">39 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
amount. In such event, if a Lender has not in fact made its share of the applicable Extension of Credit available to the Administrative Agent, then the applicable Lender and the Borrower
severally agree to pay to the Administrative Agent forthwith on demand such corresponding amount with interest thereon, for each day from and including the date such amount is made available to the Borrower to but excluding the date of payment to
the Administrative Agent, at (i)&nbsp;in the case of a payment to be made by such Lender, the greater of the Federal Funds Effective Rate and a rate determined by the Administrative Agent in accordance with banking industry rules on interbank
compensation and (ii)&nbsp;in the case of a payment to be made by the Borrower, the interest rate applicable to Alternate Base Rate Loans. If the Borrower and such Lender shall pay such interest to the Administrative Agent for the same or an
overlapping period, the Administrative Agent shall promptly remit to the Borrower the amount of such interest paid by the Borrower for such period. If such Lender pays its share of the applicable Extension of Credit to the Administrative Agent, then
the amount so paid shall constitute such Lender&#146;s Loan included in such Extension of Credit. Any payment by the Borrower shall be without prejudice to any claim the Borrower may have against a Lender that shall have failed to make such payment
to the Administrative Agent. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b)<U> Payments by Borrower; Presumptions by Administrative Agent</U>. Unless the Administrative Agent shall
have received notice from the Borrower prior to the date on which any payment is due to the Administrative Agent for the account of the Lenders or the Issuing Lenders hereunder that the Borrower will not make such payment, the Administrative Agent
may assume that the Borrower has made such payment on such date in accordance herewith and may, in reliance upon such assumption, distribute to the Lenders or the Issuing Lenders, as the case may be, the amount due. In such event, if the Borrower
has not in fact made such payment, then each of the Lenders or the Issuing Lenders, as the case may be, severally agrees to repay to the Administrative Agent forthwith on demand the amount so distributed to such Lender or such Issuing Lender, with
interest thereon, for each day from and including the date such amount is distributed to it to but excluding the date of payment to the Administrative Agent, at the greater of the Federal Funds Effective Rate and a rate determined by the
Administrative Agent in accordance with banking industry rules on interbank compensation. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">A notice of the Administrative Agent to any
Lender or the Borrower with respect to any amount owing under subsections (a)&nbsp;and (b) of this Section shall be conclusive, absent manifest error. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c)<U> Failure to Satisfy Conditions Precedent</U>. If any Lender makes available to the Administrative Agent funds for any Loan to be made by
such Lender as provided in the foregoing provisions of this <U>Article II</U>, and such funds are not made available to the Borrower by the Administrative Agent because the conditions to the applicable Extension of Credit set forth in <U>Article
IV</U> are not satisfied or waived in accordance with the terms thereof, the Administrative Agent shall return such funds (in like funds as received from such Lender) to such Lender, without interest. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d)<U> Obligations of Lenders Several</U>. The obligations of the Lenders hereunder to make Revolving Loans, to fund participations in Letters
of Credit and to make payments pursuant to Section&nbsp;9.5(c) are several and not joint. The failure of any Lender to make any Loan, to fund any such participation or to make any such payment under Section&nbsp;9.5(c) on any date required hereunder
shall not relieve any other Lender of its corresponding obligation to do so on such date, and no Lender shall be responsible for the failure of any other Lender to so make its Loan, to purchase its participation or to make its payment under
Section&nbsp;9.5(c). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e)<U> Funding Source</U>. Nothing herein shall be deemed to obligate any Lender to obtain the funds for any Loan in
any particular place or manner or to constitute a representation by any Lender that it has obtained or will obtain the funds for any Loan in any particular place or manner. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.13</B><B><U> Alternate Rate of Interest</U></B>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) If prior to the commencement of any Interest Period for a LIBOR Rate Loan: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) the Administrative Agent determines (which determination shall be conclusive absent manifest error) that adequate and
reasonable means do not exist for ascertaining the LIBOR Rate (including, without limitation, because the LIBO Screen Rate is not available or published on a current basis), for Dollars and such Interest Period; or </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">40 </P>

</DIV></Center>


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


<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">(ii) the Administrative Agent is advised by the Required Lenders that the
LIBOR Rate for such Interest Period will not adequately and fairly reflect the cost to such Lenders (or Lender) of making or maintaining their Loans (or its Loan) included in such borrowing for such Interest Period; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">then the Administrative Agent shall give notice thereof to the Borrower and the Lenders by telephone or telecopy, confirmed in writing, as promptly as
practicable thereafter, and until the Administrative Agent notifies the Borrower and the Lenders that the circumstances giving rise to such notice no longer exist, any Notice of Conversion/Extension submitted by Borrower during such period that
requests the conversion of any Revolving Loan to, or continuation of any Revolving Loan as, a LIBOR Rate Loan, shall be ineffective. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b)
If at any time the Administrative Agent determines (which determination shall be conclusive absent manifest error) that (i)&nbsp;the circumstances set forth in clause (a)(i)&nbsp;have arisen and such circumstances are unlikely to be temporary or
(ii)&nbsp;the circumstances set forth in clause (a)(i)&nbsp;have not arisen but the supervisor for the administrator of the LIBO Screen Rate or a Governmental Authority having jurisdiction over the Administrative Agent has made a public statement
identifying a specific date after which the LIBO Screen Rate shall no longer be used for determining interest rates for loans, then the Administrative Agent and the Borrower shall endeavor to establish an alternate rate of interest to the LIBOR Rate
that gives due consideration to the then prevailing market convention for determining a rate of interest for syndicated loans in the United States at such time, and shall enter into an amendment to this Agreement to reflect such alternate rate of
interest and such other related changes to this Agreement as may be applicable. Notwithstanding anything to the contrary in Section&nbsp;9.1, such amendment shall become effective without any further action or consent of any other party to this
Agreement so long as the Administrative Agent shall not have received, within ten (10)&nbsp;Business Days of the date notice of such alternate rate of interest is provided to the Lenders, a written notice from the Required Lenders stating that such
Required Lenders object to such amendment. Until an alternate rate of interest shall be determined in accordance with this clause (b) (but, in the case of the circumstances described in clause (ii)&nbsp;of the first sentence of this
Section&nbsp;2.13(b), only to the extent the LIBO Screen Rate for such Interest Period is not available or published at such time on a current basis), any Notice of Borrowing or Notice of Conversion/Extension submitted by Borrower during such period
that requests a Loan as, or the conversion of any Loans to, or continuation of any Loans as, a LIBOR Rate Loan shall be ineffective; <U>provided</U> that, if such alternate rate of interest shall be less than zero, such rate shall be deemed to be
zero for the purposes of this Agreement. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.14</B><B><U> Yield Protection</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Increased Costs Generally</U>. If any Change in Law shall: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) impose, modify or deem applicable any reserve, special deposit, compulsory loan, insurance charge or similar requirement
against assets of, deposits with or for the account of, or credit extended or participated in by, any Lender (except any reserve requirement reflected in the LIBOR Rate) or any Issuing Lender; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) subject any Recipient to any Taxes (other than Indemnified Taxes and Excluded Taxes) on or with respect to its loans,
letters of credit, commitments, or other obligations, or its deposits, reserves, other liabilities or capital actually attributable thereto; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) impose on any Lender or any Issuing Lender or the London interbank market any other condition, cost or expense affecting
this Agreement or LIBOR Rate Loans made by such Lender or any Letter of Credit or participation therein; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">and the result of any of the foregoing shall be
to increase the cost to such Lender or such other Recipient of making, converting to, continuing or maintaining any LIBOR Rate Loan or of maintaining its obligation to make any such Loan, or to increase the cost to such Lender, such Issuing Lender
or such other Recipient of participating in, issuing or maintaining any Letter of Credit (or of maintaining its obligation to participate in or to issue any Letter of Credit), or to reduce the amount of any sum received or receivable by such Lender,
such Issuing Lender or other Recipient hereunder (whether of principal, interest or any other amount) then, upon request of such Lender, such Issuing Lender or other Recipient, the Borrower will pay to such Lender, such Issuing Lender or other
Recipient, as the case may be, such additional amount or amounts as will compensate such Lender, such Issuing Lender or other Recipient, as the case may be, for such additional costs incurred or reduction suffered. The agreements in this Section
shall survive termination of this Agreement and payment of the Credit Party Obligations. </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">41 </P>

</DIV></Center>


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


<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">(b) <U>Capital Requirements</U>. If any Lender or any Issuing Lender determines that any
Change in Law affecting such Lender or such Issuing Lender or any lending office of such Lender or such Lender&#146;s or such Issuing Lender&#146;s holding company, if any, regarding capital or liquidity requirements has or would have the effect of
reducing the rate of return on such Lender&#146;s or such Issuing Lender&#146;s capital or on the capital of such Lender&#146;s or such Issuing Lender&#146;s holding company, if any, as a consequence of this Agreement, the Commitments of such Lender
or the Loans made by, or participations in Letters of Credit held by, such Lender, or the Letters of Credit issued by the such Issuing Lender, to a level below that which such Lender or such Issuing Lender or such Lender&#146;s or such Issuing
Lender&#146;s holding company could have achieved but for such Change in Law (taking into consideration such Lender&#146;s or such Issuing Lender&#146;s policies and the policies of such Lender&#146;s or such Issuing Lender&#146;s holding company
with respect to capital adequacy and liquidity), then from time to time the Borrower will pay to such Lender or such Issuing Lender, as the case may be, such additional amount or amounts as will compensate such Lender or such Issuing Lender or such
Lender&#146;s or such Issuing Lender&#146;s holding company for any such reduction suffered. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Certificates for Reimbursement</U>.
Subject to Section&nbsp;2.14(d) below, each Lender and each Issuing Lender shall promptly notify the Borrower and the Administrative Agent of any event of which it has knowledge, occurring after the date hereof, which will entitle such Lender or
such Issuing Lender, as the case may be, to compensation pursuant to this Section. Any Lender or any Issuing Lender claiming compensation under this Section shall furnish to the Borrower and the Administrative Agent a certificate of such Lender or
such Issuing Lender, as the case may be, setting forth the amount or amounts necessary to compensate such Lender or such Issuing Lender or its holding company, as the case may be, as specified in paragraph (a)&nbsp;or (b) of this Section, which
shall be conclusive absent manifest error. The Borrower shall pay such Lender or such Issuing Lender, as the case may be, the amount shown as due on any such certificate within ten (10)&nbsp;days after receipt thereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) <U>Delay in Requests</U>. Failure or delay on the part of any Lender or any Issuing Lender to demand compensation pursuant to this Section
shall not constitute a waiver of such Lender&#146;s or such Issuing Lender&#146;s right to demand such compensation, <U>provided</U> that the Borrower shall not be required to compensate a Lender or an Issuing Lender pursuant to this Section for any
increased costs incurred or reductions suffered more than 180 days prior to the date such Lender or such Issuing Lender, as the case may be, notifies the Borrower in writing of the Change in Law giving rise to such increased costs or reductions, and
of such Lender&#146;s or such Issuing Lender&#146;s intention to claim compensation therefore (except that, if the Change in Law giving rise to such increased costs or reductions is retroactive, then the
<FONT STYLE="white-space:nowrap">180-day</FONT> period referred to above shall be extended to include the period of retroactive effect thereof). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) Notwithstanding any other provision of this Section&nbsp;2.14, no Lender or Issuing Lender shall demand compensation for any increased
costs under this Section&nbsp;2.14 if it shall not be the general policy or practice of such Lender or such Issuing Lender to demand such compensation in similar circumstances and unless such demand is generally consistent with such Lender&#146;s or
such Issuing Lender&#146;s, as applicable, treatment of comparable borrowers of such Lender or Issuing Lender in the United States with respect to similarly affected commitments or loans </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.15</B><B><U> Indemnity</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Parties hereby agree to indemnify each Lender and to hold such Lender harmless from any actual funding loss or expense which such
Lender may sustain or incur as a consequence of (a)&nbsp;the failure by the Borrower to pay the principal amount of or interest on any Loan by such Lender in accordance with the terms hereof, (b)&nbsp;the failure by the Borrower to accept a
borrowing after the Borrower has given a notice in accordance with the terms hereof, (c)&nbsp;default by the Borrower in making any prepayment after the Borrower has given a notice in accordance with the terms hereof, (d)&nbsp;any assignment of a
LIBOR Rate Loan on a day other than the last day of the interest Period therefore as a result of a request by the Borrower pursuant to Section&nbsp;2.19 and/or (e)&nbsp;the making by the Borrower of a prepayment of a LIBOR Rate Loan, or the
conversion thereof, on a day which is not the last day of the Interest Period with respect thereto, in each case including, but not limited to, any such loss or expense arising from interest or fees payable by such Lender to lenders of funds
obtained by it in order to maintain its </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">42 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
LIBOR Rate Loans hereunder. A certificate setting forth in reasonable detail as to any additional amounts payable pursuant to this Section submitted by any Lender, through the Administrative
Agent, to the Borrower (which certificate must be delivered to the Administrative Agent within thirty (30)&nbsp;days following such default, prepayment, conversion or assignment) shall be conclusive in the absence of manifest error. The agreements
in this Section shall survive termination of this Agreement and payment of the Credit Party Obligations. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.16</B> <B><U>Taxes</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Payments Free of Taxes</U>. Except as otherwise required by Requirements of Law, any and all payments by or on account of any obligation
of any Credit Party hereunder or under any other Credit Document shall be made free and clear of and without reduction or withholding for any Taxes, <U>provided</U> that if any applicable withholding agent shall be required by applicable law to
deduct any Taxes from such payments, then (i)&nbsp;if such Taxes are Indemnified Taxes (including any Other Taxes), the sum payable shall be increased as necessary so that after making all required deductions (including deductions applicable to
additional sums payable under this Section) the applicable Lender (or, in the case of payments made to the Administrative Agent for its own account, the Administrative Agent), receives an amount equal to the sum it would have received had no such
deductions been made, (ii)&nbsp;the applicable withholding agent shall make such deductions and (iii)&nbsp;the applicable withholding agent shall timely pay the full amount deducted to the relevant Governmental Authority in accordance with
Requirements of Law. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Payment of Other Taxes by the Borrower</U>. Without limiting the provisions of paragraph (a)&nbsp;above, the
Borrower shall timely pay any Other Taxes to the relevant Governmental Authority in accordance with Requirements of Law. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c)
<U>Indemnification by the Borrower</U>. The Borrower shall indemnify the Administrative Agent and each Lender, within ten (10)&nbsp;days after demand therefor, for the full amount of any Indemnified Taxes or Other Taxes (including Indemnified Taxes
or Other Taxes imposed or asserted on or attributable to amounts payable under this Section) paid by the Administrative Agent or such Lender, as the case may be, and any penalties, interest and reasonable expenses arising therefrom or with respect
thereto, whether or not such Indemnified Taxes or Other Taxes were correctly or legally imposed or asserted by the relevant Governmental Authority. A&nbsp;certificate as to the amount of such payment or liability (setting forth in reasonable detail
the basis for such demand) delivered to the Borrower by a Lender (with a copy to the Administrative Agent), or by the Administrative Agent on its own behalf or on behalf of a Lender, shall be conclusive absent manifest error. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) <U>Evidence of Payments</U>. As soon as practicable after any payment of any Taxes by the Borrower to a Governmental Authority, the
Borrower shall deliver to the Administrative Agent the original or a certified copy of a receipt issued by such Governmental Authority evidencing such payment, a copy of the return reporting such payment or other evidence of such payment reasonably
satisfactory to the Administrative Agent. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) <U>Status of Lenders</U>. Each Lender that is entitled to an exemption from or reduction of
any applicable withholding Tax with respect to payments hereunder or under any other Credit Document shall deliver to the Borrower (with a copy to the Administrative Agent), at the time or times prescribed by Requirements of Law or reasonably
requested by the Borrower or the Administrative Agent, such properly completed and executed documentation prescribed by Requirements of Law as will permit such payments to be made without withholding or at a reduced rate of withholding. Each such
Lender shall, whenever a lapse in time or change in circumstances renders any such documentation (including any specific documentation required below in Section&nbsp;2.16(f)) obsolete, expired or inaccurate in any respect, deliver promptly to the
Borrower and the Administrative Agent updated or other appropriate documentation (including any new documentation reasonably requested by the Borrower or the Administrative Agent) or promptly notify the Borrower and the Administrative Agent in
writing of its legal ineligibility to do so. In addition, any Lender, if requested by the Borrower or the Administrative Agent, shall deliver such other documentation prescribed by Requirements of Law or reasonably requested by the Borrower or the
Administrative Agent as will enable the Borrower or the Administrative Agent to determine whether or not such Lender is subject to backup withholding or information reporting requirements. </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">43 </P>

</DIV></Center>


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


<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">(f) Without limiting the generality of the foregoing, </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) each U.S. Lender shall deliver to the Borrower and the Administrative Agent on or prior to the date on which such U.S.
Lender becomes a Lender under this Agreement (and from time to time thereafter upon the request of the Borrower or the Administrative Agent) two duly completed originals of Internal Revenue Service Form <FONT STYLE="white-space:nowrap">W-9</FONT>
certifying that such U.S. Lender is exempt from United States federal backup withholding. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) each Foreign Lender shall
deliver to the Borrower and the Administrative Agent on or prior to the date on which such Foreign Lender becomes a Lender under this Agreement (and from time to time thereafter upon the request of the Borrower or the Administrative Agent),
whichever of the following is applicable: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(A) two duly completed originals of Internal Revenue Service Form <FONT
STYLE="white-space:nowrap">W-8BEN</FONT> or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">W-8BEN-E</FONT></FONT> (or any successor forms) claiming eligibility for benefits of an income tax treaty to which the United States of
America is a party, </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(B) two duly completed originals of Internal Revenue Service Form
<FONT STYLE="white-space:nowrap">W-8ECI</FONT> (or any successor forms), </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(C) in the case of a Foreign Lender claiming the
benefits of the exemption for portfolio interest under section 881(c) of the Code, (i)&nbsp;a certificate to the effect that such Foreign Lender is not (A)&nbsp;a &#147;bank&#148; within the meaning of section 881(c)(3)(A) of the Code, (B)&nbsp;a
&#147;10&nbsp;percent shareholder&#148; of the Borrower within the meaning of section 881(c)(3)(B) of the Code, or (C)&nbsp;a &#147;controlled foreign corporation&#148; described in section&nbsp;881(c)(3)(C) of the Code and that no payments in
connection with any Credit Document are effectively connected with such Lender&#146;s conduct of a United States trade or business (a &#147;United States Tax Compliance Certificate&#148;) and (ii)&nbsp;two duly completed originals of Internal
Revenue Service Form <FONT STYLE="white-space:nowrap">W-8BEN</FONT> or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">W-8BEN-E</FONT></FONT> (or any successor forms), </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(D) to the extent a Foreign Lender is not the beneficial owner of a Loan (for example, where the Foreign Lender is a
partnership or a participating Lender), two duly completed originals of Internal Revenue Service Form <FONT STYLE="white-space:nowrap">W-8IMY</FONT> (or any successor forms) of the Foreign Lender, accompanied by a Form
<FONT STYLE="white-space:nowrap">W-8ECI,</FONT> <FONT STYLE="white-space:nowrap">W-8BEN</FONT> or <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">W-8BEN-E,</FONT></FONT> United States Tax Compliance Certificate, Form <FONT
STYLE="white-space:nowrap">W-9,</FONT> Form <FONT STYLE="white-space:nowrap">W-8IMY</FONT> or any other required information (or any successor forms) from each beneficial owner that would be required under this Section&nbsp;2.16(f) if such
beneficial owner were a Lender, as applicable (provided that if the Foreign Lender is a partnership (and not a participating Lender) and one or more direct or indirect partners are claiming the portfolio interest exemption, the United States Tax
Compliance Certificate may be provided by such Foreign Lender on behalf of such direct or indirect partner(s)), or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(E) any
other form prescribed by Requirements of Law as a basis for claiming exemption from or a reduction in United States federal withholding Tax duly completed together with such supplementary documentation as may be prescribed by Requirements of Law to
permit the Borrower or Administrative Agent to determine the withholding or deduction required to be made. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) If a
payment made to a Lender under any Credit Document would be subject to United States federal withholding Tax imposed by FATCA if such Lender were to fail to comply with the applicable reporting requirements of FATCA (including those contained in
Sections 1471(b) or 1472(b) of the Code, as applicable), such Lender shall deliver to the Borrower and the Administrative Agent at the time or times prescribed by Requirements of Law and at such time or times reasonably requested by the Borrower or
the Administrative Agent such documentation prescribed by Requirements of Law (including as prescribed by Section&nbsp;1471(b)(3)(C)(i) of the Code) and such additional documentation reasonably requested by the Borrower or the Administrative Agent
as may be necessary for the Borrower and the Administrative Agent to comply with their FATCA obligations, to determine whether such Lender has or has not complied with such Lender&#146;s FATCA obligations and to determine the amount, if any, to
deduct and withhold from such payment; <U>provided</U>, <U>however</U>, that the Borrower shall have no obligation to request any documentation or take any other action to decrease any withholding obligation under FATCA. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">44 </P>

</DIV></Center>


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


<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">(iv) Notwithstanding any other provision of Section&nbsp;2.16(e) or this
Section&nbsp;2.16(f), a Lender shall not be required to deliver any documentation that such Lender is not legally eligible to deliver. Each Lender hereby authorizes the Administrative Agent to deliver to the Credit Parties and to any successor
Administrative Agent any documentation provided by such Lender pursuant to these Sections 2.16(e) and (f). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(g) <U>Treatment of Certain
Refunds</U>. If the Administrative Agent or a Lender determines, in its sole discretion, that it has received a refund of any Indemnified Taxes or Other Taxes as to which it has been indemnified by any Credit Party or with respect to which any
Credit Party has paid additional amounts pursuant to this Section, it shall pay to such Credit Party an amount equal to such refund (but only to the extent of indemnity payments made, or additional amounts paid, by such Credit Party under this
Section&nbsp;2.16 with respect to the Indemnified Taxes or Other Taxes giving rise to such refund), net of all <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> expenses (including any Taxes) of the
Administrative Agent or such Lender, as the case may be, and without interest (other than any interest paid by the relevant Governmental Authority with respect to such refund), <U>provided</U> that such Credit Party, upon the request of the
Administrative Agent or such Lender shall repay the amount paid over to such Credit Party (plus any penalties, interest or other charges imposed by the relevant Governmental Authority) to the Administrative Agent or such Lender in the event the
Administrative Agent or such Lender is required to repay such refund to such Governmental Authority. This paragraph shall not be construed to require the Administrative Agent or any Lender to make available its tax returns (or any other information
relating to its Taxes that it deems confidential) to the Borrower or any other Person. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(h) For the avoidance of doubt, the term
&#147;Lender&#148; shall, for purposes of this Section&nbsp;2.16, include any Issuing Lender. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.17</B>
<B><U>Indemnification; Nature of Issuing Lenders&#146; Duties</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) In addition to its other obligations under Section&nbsp;2.3,
the Credit Parties hereby agree to protect, indemnify, pay and save each Issuing Lender and each Lender harmless from and against any and all claims, demands, liabilities, damages, losses, costs, charges and expenses (including reasonable and
documented attorneys&#146; fees) that such Issuing Lender or such Lender may incur or be subject to as a consequence, direct or indirect, of (i)&nbsp;the issuance of any Letter of Credit or (ii)&nbsp;the failure of any Issuing Lender to honor a
drawing under any Letter of Credit as a result of any act or omission, whether rightful or wrongful, of any present or future de jure or de facto government or Governmental Authority (all such acts or omissions, herein called &#147;<U>Government
Acts</U>&#148;). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) As among the Credit Parties, each Issuing Lender and each Lender, the Credit Parties shall assume all risks of the
acts, omissions or misuse of any Letter of Credit by the beneficiary thereof. In the absence of their gross negligence or willful misconduct, neither any Issuing Lender nor any Lender shall be responsible: (i)&nbsp;for the form, validity,
sufficiency, accuracy, genuineness or legal effect of any document submitted by any party in connection with the application for and issuance of any Letter of Credit, even if it should in fact prove to be in any or all respects invalid,
insufficient, inaccurate, fraudulent or forged; (ii)&nbsp;for the validity or sufficiency of any instrument transferring or assigning or purporting to transfer or assign any Letter of Credit or the rights or benefits thereunder or proceeds thereof,
in whole or in part, that may prove to be invalid or ineffective for any reason; (iii)&nbsp;for failure of the beneficiary of a Letter of Credit to comply fully with conditions required in order to draw upon a Letter of Credit; (iv)&nbsp;for errors,
omissions, interruptions or delays in transmission or delivery of any messages, by mail, cable, telegraph, telex or otherwise, whether or not they be in cipher; (v)&nbsp;for errors in interpretation of technical terms; (vi)&nbsp;for any loss or
delay in the transmission or otherwise of any document required in order to make a drawing under a Letter of Credit or of the proceeds thereof; and (vii)&nbsp;for any consequences arising from causes beyond the control of any Issuing Lender or any
Lender, including, without limitation, any Government Acts. None of the above shall affect, impair, or prevent the vesting of the Issuing Lenders&#146; rights or powers hereunder. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) In furtherance and extension and not in limitation of the specific provisions hereinabove set forth, any action taken or omitted by any
Issuing Lender or any Lender, under or in connection with any Letter of Credit or the related certificates, if taken or omitted in the absence of gross negligence or willful misconduct, shall not put such Issuing Lender or such Lender under any
resulting liability to the Credit Parties. It is the intention of the parties that this Agreement shall be construed and applied to protect and indemnify each Issuing Lender and each Lender against any and all risks involved in the issuance of the
Letters of Credit, all of which risks are hereby </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">45 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
assumed by the Credit Parties, including, without limitation, any and all risks of the acts or omissions, whether rightful or wrongful, of any Government Authority. The Issuing Lenders and the
Lenders shall not, in any way, be liable for any failure by the Issuing Lenders or anyone else to pay any drawing under any Letter of Credit as a result of any Government Acts or any other cause beyond the control of the Issuing Lenders and the
Lenders. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) Nothing in this Section is intended to limit the Reimbursement Obligation of the Borrower contained in Section&nbsp;2.3(d)
hereof. The obligations of the Credit Parties under this Section shall survive the termination of this Agreement. No act or omissions of any current or prior beneficiary of a Letter of Credit shall in any way affect or impair the rights of the
Issuing Lenders and the Lenders to enforce any right, power or benefit under this Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) Notwithstanding anything to the contrary
contained in this Section, the Credit Parties shall have no obligation to indemnify any Issuing Lender or any Lender in respect of any liability incurred by such Issuing Lender or such Lender arising out of the gross negligence or willful misconduct
of the Issuing Lenders (including action not taken by such Issuing Lender or such Lender), as determined by a court of competent jurisdiction or pursuant to arbitration. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.18</B> <B><U>Illegality</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding any other provision of this Credit Agreement, if any Change in Law shall make it unlawful for such Lender or its LIBOR Lending
Office to make or maintain LIBOR Rate Loans as contemplated by this Credit Agreement or to obtain in the interbank eurodollar market through its LIBOR Lending Office the funds with which to make such Loans, (a)&nbsp;such Lender shall promptly notify
the Administrative Agent and the Borrower thereof, (b)&nbsp;the commitment of such Lender hereunder to make LIBOR Rate Loans or continue LIBOR Rate Loans as such shall forthwith be suspended until the Administrative Agent shall give notice that the
condition or situation which gave rise to the suspension shall no longer exist, and (c)&nbsp;such Lender&#146;s Loans then outstanding as LIBOR Rate Loans, if any, shall be converted on the last day of the Interest Period for such Loans or within
such earlier period as required by law as Alternate Base Rate Loans. The Borrower hereby agrees to promptly pay any Lender, upon its demand, any additional amounts necessary to compensate such Lender for actual and direct costs (but not including
anticipated profits) reasonably incurred by such Lender in making any repayment in accordance with this Section including, but not limited to, any interest or fees payable by such Lender to lenders of funds obtained by it in order to make or
maintain its LIBOR Rate Loans hereunder. A certificate (which certificate shall include a description of the basis for the computation) as to any additional amounts payable pursuant to this Section submitted by such Lender, through the
Administrative Agent, to the Borrower shall be conclusive in the absence of manifest error. Each Lender agrees to use reasonable efforts (including reasonable efforts to change its LIBOR Lending Office) to avoid or to minimize any amounts which may
otherwise be payable pursuant to this Section; <U>provided</U>, <U>however</U>, that such efforts shall not cause the imposition on such Lender of any additional costs or legal or regulatory burdens deemed by such Lender in its sole discretion to be
material. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.19</B> <B><U>Replacement of Lenders</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Designation of a Different Lending Office</U>. If any Lender requests compensation under Section&nbsp;2.14, or requires the Borrower to
pay any additional amount to any Lender or any Governmental Authority for the account of any Lender pursuant to Section&nbsp;2.16 or 2.18, then such Lender shall use reasonable efforts to designate a different lending office for funding or booking
its Loans hereunder or to assign its rights and obligations hereunder to another of its offices, branches or affiliates, if, in the reasonable judgment of such Lender, such designation or assignment (i)&nbsp;would eliminate or reduce amounts payable
pursuant to Section&nbsp;2.14, Section&nbsp;2.16 or Section&nbsp;2.18, as the case may be, in the future and (ii)&nbsp;would not subject such Lender to any unreimbursed cost or expense and would not otherwise be disadvantageous to such Lender. The
Borrower hereby agrees to pay all reasonable costs and expenses incurred by any Lender in connection with any such designation or assignment. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Replacement of Lenders</U>. (i)&nbsp;If any Lender requests compensation under Section&nbsp;2.14 or if the Borrower is required to pay
any additional amount to any Lender or any Governmental Authority for the account of any Lender pursuant to Section&nbsp;2.16 or Section&nbsp;2.18 and, in each case, such Lender has declined or is unable to designate a different lending office in
accordance with Section&nbsp;2.19(a) or (ii)&nbsp;if any Lender is a Defaulting Lender or a <FONT STYLE="white-space:nowrap">Non-Consenting</FONT> Lender, then the Borrower may, at its sole expense and effort, upon notice to such Lender and the
</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">46 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
Administrative Agent, require such Lender to assign and delegate, without recourse (in accordance with and subject to the restrictions contained in, and consents required by, Section&nbsp;9.6),
all of its interests, rights (other than its existing rights to payments pursuant to Section&nbsp;2.14, Section&nbsp;2.16 or Section&nbsp;2.18) and obligations under this Agreement and the related Credit Documents to an Eligible Assignee that shall
assume such obligations (which assignee may be another Lender, if a Lender accepts such assignment), <U>provided</U> that: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(A) the Borrower shall have paid to the Administrative Agent the assignment fee specified in Section&nbsp;9.6; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(B) such Lender shall have received payment of an amount equal to the outstanding principal of its Loans and participations in
Letters of Credit, accrued interest thereon, accrued fees and all other amounts payable to it hereunder and under the other Credit Documents (including any amounts under Section&nbsp;2.15) from the assignee (to the extent of such outstanding
principal and accrued interest and fees) or the Borrower (in the case of all other amounts); </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(C) in the case of any such
assignment resulting from a claim for compensation under Section&nbsp;2.14 or payments required to be made pursuant to Section&nbsp;2.16 or Section&nbsp;2.18, such assignment will result in a reduction in such compensation or payments thereafter;
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(D) such assignment does not conflict with Requirements of Law; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(E) in the case of any assignment resulting from a Lender becoming a <FONT STYLE="white-space:nowrap">Non-Consenting</FONT>
Lender, the applicable assignee shall have consented to the applicable amendment, waiver or consent. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">A Lender shall not be required to
make any such assignment or delegation if, prior thereto, as a result of a waiver by such Lender or otherwise, the circumstances entitling the Borrower to require such assignment and delegation cease to apply. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.20</B> <B><U>Cash Collateral</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a)<U> Cash Collateral</U>. At any time that there shall exist a Defaulting Lender, within one (1)&nbsp;Business Day following the written
request of the Administrative Agent, the Issuing Lenders (with a copy to the Administrative Agent), the Borrower shall Cash Collateralize all Fronting Exposure of the Issuing Lenders with respect to such Defaulting Lender (determined after giving
effect to Section&nbsp;2.21(a)(iv) and Section&nbsp;2.21(b) and any Cash Collateral provided by the Defaulting Lender). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Grant of
Security Interest</U>. The Borrower, and to the extent provided by any Defaulting Lender, such Defaulting Lender, hereby grants to the Administrative Agent, for the benefit of the Administrative Agent, the Issuing Lenders and the Lenders, and agrees
to maintain, a first priority security interest in all such Cash Collateral as security for the Defaulting Lenders&#146; obligations to which such Cash Collateral may be applied pursuant to clause (c)&nbsp;below. If at any time the Administrative
Agent or any Issuing Lender determines that Cash Collateral is subject to any right or claim of any Person other than the Administrative Agent as herein provided, or that the total amount of such Cash Collateral is less than the applicable Fronting
Exposure, the Borrower will, promptly upon demand by the Administrative Agent or such Issuing Lender, pay or provide to the Administrative Agent additional Cash Collateral in an amount sufficient to eliminate such deficiency (after giving effect to
any Cash Collateral provided by the Defaulting Lender). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Application</U>. Notwithstanding anything to the contrary contained in
this Agreement, Cash Collateral provided under any of this Section or Section&nbsp;2.21 in respect of Letters of Credit, shall be held and applied to the satisfaction of the specific LOC Obligations, obligations to fund participations therein
(including, as to Cash Collateral provided by a Defaulting Lender, any interest accrued on such obligation) and other obligations for which the Cash Collateral was so provided, prior to any other application of such property as may be provided for
herein. </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">47 </P>

</DIV></Center>


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


<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">(d) <U>Termination of Requirement</U>. Cash Collateral (or the appropriate portion thereof)
provided to reduce Fronting Exposure or other obligations shall no longer be required to be held as Cash Collateral pursuant to this Section&nbsp;2.20 and shall promptly be released to the Person providing such Cash Collateral following (i)&nbsp;the
elimination of the applicable Fronting Exposure or other obligations giving rise thereto (including by the termination of Defaulting Lender status of the applicable Lender), or (ii)&nbsp;the determination by the Administrative Agent or any Issuing
Lender that there exists excess Cash Collateral; <U>provided</U> that, subject to Section&nbsp;2.21, the Person providing Cash Collateral and the applicable Issuing Lenders may agree that Cash Collateral shall be held to support future anticipated
Fronting Exposure or other obligations. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;2.21</B> <B><U>Defaulting Lenders</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Defaulting Lender Adjustments</U>. Notwithstanding anything to the contrary contained in this Agreement, if any Lender becomes a
Defaulting Lender, then, until such time as such Lender is no longer a Defaulting Lender, to the extent permitted by applicable law: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) <U>Waivers and Amendments</U>. Such Defaulting Lender&#146;s right to approve or disapprove any amendment, waiver or
consent with respect to this Agreement shall be restricted as set forth in the definition of Required Lenders and Section&nbsp;9.1. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) <U>Defaulting Lender Waterfall</U>. Any payment of principal, interest, fees or other amounts received by the
Administrative Agent for the account of such Defaulting Lender (whether voluntary or mandatory, at maturity, pursuant to Article VII or otherwise) or received by the Administrative Agent from a Defaulting Lender pursuant to Section&nbsp;9.7 shall be
applied at such time or times as may be determined by the Administrative Agent as follows: <I>first</I>, to the payment of any amounts owing by such Defaulting Lender to the Administrative Agent hereunder; <I>second</I>, to the payment on a pro rata
basis of any amounts owing by such Defaulting Lender to the Issuing Lenders hereunder; <I>third</I>, to Cash Collateralize the Issuing Lenders&#146; Fronting Exposure in accordance with Section&nbsp;2.20; <I>fourth</I>, as the Borrower may request
(so long as no Default or Event of Default exists), to the funding of any Loan in respect of which such Defaulting Lender has failed to fund its portion thereof as required by this Agreement, as determined by the Administrative Agent; <I>fifth</I>,
if so determined by the Administrative Agent and the Borrower, to be held in a <FONT STYLE="white-space:nowrap">non-interest</FONT> bearing deposit account and released pro rata in order to (x)&nbsp;satisfy such Defaulting Lender&#146;s potential
future funding obligations with respect to Loans under this Agreement and (y)&nbsp;Cash Collateralize the Issuing Lenders&#146; future Fronting Exposure with respect to such Defaulting Lender with respect to future Letters of Credit issued under
this Agreement in accordance with Section&nbsp;2.20; <I>sixth</I>, to the payment of any amounts owing to the Lenders, the Issuing Lenders as a result of any judgment of a court of competent jurisdiction obtained by any Lender or by any Issuing
Lender against such Defaulting Lender as a result of such Defaulting Lender&#146;s breach of its obligations under this Agreement; <I>seventh</I>, so long as no Default or Event of Default exists, to the payment of any amounts owing to the Borrower
as a result of any judgment of a court of competent jurisdiction obtained by the Borrower against such Defaulting Lender as a result of such Defaulting Lender&#146;s breach of its obligations under this Agreement; and <I>eighth</I>, to such
Defaulting Lender or as otherwise directed by a court of competent jurisdiction; <U>provided</U> that if (A)&nbsp;such payment is a payment of the principal amount of any Loans or LOC Obligations in respect of which such Defaulting Lender has not
fully funded its appropriate share and (B)&nbsp;such Loans were made or the related Letters of Credit were issued at a time when the conditions set forth in Section&nbsp;4.2 were satisfied or waived, such payment shall be applied solely to pay the
Loans of, and LOC Obligations owed to, all <FONT STYLE="white-space:nowrap">Non-Defaulting</FONT> Lenders on a pro rata basis prior to being applied to the payment of any Loans of, or LOC Obligations owed to, such Defaulting Lender until such time
as all Loans and funded and unfunded participations in LOC Obligations are held by the Lenders pro rata in accordance with the Commitments under the applicable facility without giving effect to Section&nbsp;2.21(a) (iv). Any payments, prepayments or
other amounts paid or payable to a Defaulting Lender that are applied (or held) to pay amounts owed by a Defaulting Lender or to post Cash Collateral pursuant to this Section&nbsp;2.21(a)(ii) shall be deemed paid to and redirected by such Defaulting
Lender, and each Lender irrevocably consents hereto. </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">48 </P>

</DIV></Center>


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


<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">(iii) <U>Certain Fees</U>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(A) <U>Unused Commitment Fees</U>. No Defaulting Lender shall be entitled to receive any Unused Commitment Fee for any period
during which that Lender is a Defaulting Lender (and the Borrower shall not be required to pay any such fee that otherwise would have been required to have been paid to that Defaulting Lender). </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(B) <U>Letter of Credit Fees</U>. Each Defaulting Lender shall be entitled to receive Letter of Credit Fees for any period
during which that Lender is a Defaulting Lender only to the extent allocable to its Revolving Commitment Percentage of the stated amount of Letters of Credit for which it has provided Cash Collateral pursuant Section&nbsp;2.20. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(C) <U>Reallocation of Fees</U>. With respect to any Letter of Credit Fee not required to be paid to any Defaulting Lender
pursuant to clause (B)&nbsp;above, the Borrower shall (x)&nbsp;pay to each <FONT STYLE="white-space:nowrap">Non-Defaulting</FONT> Lender that portion of any such fee otherwise payable to such Defaulting Lender with respect to such Defaulting
Lender&#146;s participation in LOC Obligations that has been reallocated to such <FONT STYLE="white-space:nowrap">Non-Defaulting</FONT> Lender pursuant to clause (iv)&nbsp;below, (y) pay to each Issuing Lender, the amount of any such fee otherwise
payable to such Defaulting Lender to the extent allocable to such Issuing Lender&#146; Fronting Exposure to such Defaulting Lender, and (z)&nbsp;not be required to pay the remaining amount of any such fee. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iv) <U>Reallocation of Participations to Reduce Fronting Exposure</U>. All or any part of such Defaulting Lender&#146;s
participation in LOC Obligations shall be reallocated among the <FONT STYLE="white-space:nowrap">Non-Defaulting</FONT> Lenders in accordance with their respective Revolving Commitment Percentage (calculated without regard to such Defaulting
Lender&#146;s Revolving Commitment) but only to the extent that (x)&nbsp;the conditions set forth in Section&nbsp;4.2 are satisfied at the time of such reallocation (and, unless the Borrower shall have otherwise notified the Administrative Agent at
such time, the Borrower shall be deemed to have represented and warranted that such conditions are satisfied at such time) and (y)&nbsp;such reallocation does not cause the aggregate Committed Funded Exposure of any
<FONT STYLE="white-space:nowrap">Non-Defaulting</FONT> Lender to exceed such <FONT STYLE="white-space:nowrap">Non-Defaulting</FONT> Lender&#146;s Revolving Commitment. Subject to Section&nbsp;9.27, no reallocation hereunder shall constitute a waiver
or release of any claim of any party hereunder against a Defaulting Lender arising from that Lender having become a Defaulting Lender, including any claim of a <FONT STYLE="white-space:nowrap">Non-Defaulting</FONT> Lender as a result of such <FONT
STYLE="white-space:nowrap">Non-Defaulting</FONT> Lender&#146;s increased exposure following such reallocation. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(v) <U>Cash
Collateral</U>. If the reallocation described in clause (iv)&nbsp;above cannot, or can only partially, be effected, the Borrower shall, without prejudice to any right or remedy available to it hereunder or under law, Cash Collateralize the Issuing
Lenders&#146; Fronting Exposure in accordance with the procedures set forth in Section&nbsp;2.20. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Defaulting Lender Cure</U>. If
the Borrower, the Administrative Agent and the Issuing Lenders agree in writing that a Lender is no longer a Defaulting Lender, the Administrative Agent will so notify the parties hereto, whereupon as of the effective date specified in such notice
and subject to any conditions set forth therein (which may include arrangements with respect to any Cash Collateral), that Lender will, to the extent applicable, purchase at par that portion of outstanding Loans of the other Lenders or take such
other actions as the Administrative Agent may determine to be necessary to cause the Loans and funded and unfunded participations in Letters of Credit to be held on a pro rata basis by the Lenders in accordance with their Revolving Commitment
Percentages (without giving effect to Section&nbsp;2.21(a)(iv)), whereupon such Lender will cease to be a Defaulting Lender; <U>provided</U> that no adjustments will be made retroactively with respect to fees accrued or payments made by or on behalf
of the Borrower while that Lender was a Defaulting Lender; and <U>provided</U>, further, that except to the extent otherwise expressly agreed by the affected parties, no change hereunder from Defaulting Lender to Lender will constitute a waiver or
release of any claim of any party hereunder arising from that Lender&#146;s having been a Defaulting Lender. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>New Letters of
Credit</U>. So long as any Lender is a Defaulting Lender, no Issuing Lender shall be required to issue, extend, renew or increase any Letter of Credit unless it is reasonably satisfied that it will have no Fronting Exposure after giving effect
thereto. </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">49 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;2.22</B> <B><U>Incremental Facilities</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Subject to the terms and conditions set forth herein and so long as no Default or Event of Default has occurred and is continuing, the
Borrower shall have the right, at any time and from time to time prior to the Maturity Date, to incur additional Indebtedness under this Credit Agreement in the form of (i)&nbsp;one or more increases to the Revolving Committed Amount (each an
&#147;<U>Increased Revolver Commitment</U>&#148;) which shall constitute one and the same Facility as the existing Revolving Commitments or (ii)&nbsp;one or more commitments (each, an &#147;<U>Incremental Facility Commitment</U>&#148;, and together
with the Increased Revolver Commitments, the &#147;<U>Incremental Commitments</U>&#148;) for term loan facilities which shall constitute a new Facility as provided in 2.22(d) below (an &#147;<U>Incremental Facility,</U>&#148; and the loans
thereunder, &#147;<U>Incremental Loans</U>&#148;), up to a maximum<U> </U>aggregate amount of Incremental Commitments not to exceed $400,000,000; <U>provided</U> that, if the Collateral Event has occurred, the aggregate amount of all Incremental
Commitments shall not exceed at the time any such Incremental Commitments are entered into the greater of (x) $400,000,000 and (y)&nbsp;an amount such that, on a Pro Forma Basis after giving effect to such Incremental Commitments (and assuming such
Incremental Commitments are fully drawn and/or funded, as applicable, and applied for the purpose intended) the Consolidated Net Leverage Ratio does not exceed 3.00 to 1.00. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) The following terms and conditions shall apply to each Increased Revolver Commitment: (i)&nbsp;Obligations thereunder shall constitute
Credit Party Obligations and will be guaranteed (and secured, to the extent applicable) with the other Credit Party Obligations on a pari passu basis and will not be guaranteed by any obligor or secured by any assets that do not guarantee or secure,
respectively, the Credit Party Obligations, (ii)&nbsp;each Increased Revolver Commitment shall have the same terms (including interest rate and maturity date but other than with respect to any upfront fees) as the existing Revolving Commitments,
(iii)&nbsp;each Increased Revolver Commitment shall be entitled to the same voting rights as the existing Revolving Commitments, voting as one class, and shall be entitled to receive a pro rata share of proceeds of prepayments on the same basis as
the existing Revolving Loans and shall be considered an increase to the existing Revolving Commitments, (iv)&nbsp;each Increased Revolver Commitment shall be obtained from existing Lenders or from other banks, financial institutions or Funds, in
each case in accordance with the terms set forth below, (v)&nbsp;the proceeds of all Loans thereunder will be used for the purposes set forth in Section&nbsp;3.11, (vi) the Borrower shall execute a Note in favor of any new Lender or any existing
Lender requesting a Note whose Revolving Commitment is increased, (vii)&nbsp;on the effective date of each such increase, the conditions to Extensions of Credit in Section&nbsp;4.2 shall have been satisfied, (viii)&nbsp;each such Increased Revolver
Commitment shall be in a minimum amount of $5,000,000 (and $1,000,000 increments in excess thereof), and (ix)&nbsp;the Administrative Agent shall have received from the Borrower (A)&nbsp;resolutions, legal opinions and other corporate authority
documents reasonably requested by the Administrative Agent, substantially the same in form and substance as those delivered on the Closing Date pursuant to Section&nbsp;4.1 and (B)&nbsp;updated financial projections and an officer&#146;s
certificate, in each case in form and substance reasonably satisfactory to the Administrative Agent, demonstrating that, after giving effect to such Increased Revolver Commitment and any borrowings thereunder and the application thereof on a Pro
Forma Basis, the Credit Parties will be in compliance with the financial covenants set forth in Section&nbsp;5.9 (and, if the Collateral Event has occurred, the condition in the proviso set forth in Section&nbsp;2.22(a)) and no Default or Event of
Default shall exist. Any new banks, financial institutions and Funds that become Revolving Lenders that were not previously Lenders hereunder shall enter into such joinder agreements to give effect thereto as the Administrative Agent may reasonably
request. In connection with the closing of any Increased Revolver Commitment, the outstanding Revolving Loans and Participation Interests shall be reallocated by causing such fundings and repayments (which shall not be subject to any processing
and/or recordation fees) among the Revolving Lenders (with the Borrower responsible for any costs arising under Section&nbsp;2.15 resulting from such reallocation and repayments) of Revolving Loans as necessary such that, after giving effect to such
Increased Revolver Commitments, each Revolving Lender will hold Revolving Loans and Participation Interests based on its Revolving Commitment Percentage (after giving effect to such Increased Revolver Commitments). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) The following terms and conditions shall apply to each Incremental Facility: (i)&nbsp;Obligations thereunder shall constitute Credit Party
Obligations and will be guaranteed (and secured, to the extent applicable) with the other Credit Party Obligations on a pari passu basis and will not be guaranteed by any obligor or secured by any assets that do not guarantee or secure,
respectively, the Credit Party Obligations, (ii)&nbsp;each Incremental Facility shall otherwise have terms (including pricing terms) to be agreed by the Borrower and the Lenders providing the Incremental Commitments (the &#147;<U>Incremental
Lenders</U>&#148;) subject to the following parameters: (A)&nbsp;no Incremental Facility shall mature prior to the Maturity Date applicable to the Revolving Loans, (B)&nbsp;mandatory prepayments customary for a term loan (which for the avoidance of
doubt may include prepayments with the proceeds of non-</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">50 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
ordinary course asset sales and &#147;excess cash flow&#148; (to be defined in a manner satisfactory to the Borrower and the Administrative Agent)) may be included on then-market terms, and
(C)&nbsp;all terms of any Incremental Facility not set forth herein, shall be reasonably satisfactory to the Administrative Agent, (iii)&nbsp;each Incremental Facility shall constitute a separate Facility hereunder, and shall be incorporated into
the Credit Documents such that the Incremental Lenders have similar rights and privileges to the Lenders, (iv)&nbsp;each Incremental Facility shall be obtained from existing Lenders or from other banks, financial institutions or Funds, in each case
in accordance with the terms set forth below; provided that any Lender or any Incremental Lender offered or approached to provide all or a portion of any Incremental Facility Commitment may elect or decline, in its sole discretion, to provide such
Incremental Facility Commitment, (v)&nbsp;the proceeds of each Incremental Facility will be used for the purposes set forth in Section&nbsp;3.11, (vi) the Borrower shall execute a Note in favor of any Incremental Lender requesting a Note
representing its Loans under the Incremental Facility, (vii)&nbsp;on the date of incurrence of the Incremental Loans, the conditions to Extensions of Credit in Section&nbsp;4.2 shall have been satisfied, (viii)&nbsp;each such commitment for an
Incremental Facility shall be in a minimum amount of $5,000,000 (and $1,000,000 increments in excess thereof), and (ix)&nbsp;the Administrative Agent shall have received from the Borrower (A)&nbsp;resolutions, legal opinions and other corporate
authority documents reasonably requested by the Administrative Agent, substantially the same in form and substance as those delivered on the Closing Date pursuant to Section&nbsp;4.1 and (B)&nbsp;updated financial projections and an officer&#146;s
certificate, in each case in form and substance reasonably satisfactory to the Administrative Agent, demonstrating that, after giving effect to the borrowing of such Incremental Loans and the application thereof on a Pro Forma Basis, the Credit
Parties will be in compliance with the financial covenants set forth in Section&nbsp;5.9 (and, if the Collateral Event has occurred, the condition in the proviso set forth in Section&nbsp;2.22(a)) and no Default or Event of Default shall exist. All
Incremental Lenders shall enter into such joinder agreements to give effect thereto as the Administrative Agent may reasonably request. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) Notwithstanding anything to the contrary in Section&nbsp;9.1 or elsewhere in this Credit Agreement, the Administrative Agent is authorized
to enter into, on behalf of the Lenders, any amendment to this Credit Agreement or any other Credit Document as may be necessary solely to incorporate the terms of each Increased Revolver Commitment or Incremental Facility therein. For the avoidance
of doubt, such amendments may provide for, among other things, the incorporation of such Incremental Facility into the definitions of &#147;Required Lenders&#148;, &#147;Required Facility Lenders&#148;, &#147;Commitment Percentage&#148;, and similar
terms and sections of this Credit Agreement on a similar basis to each other existing Facility, and may provide for sharing of payments and inclusion in the waterfall, and the inclusion of customary provisions for a term loan throughout the Credit
Documents.\ </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) Upon executing the joinder documentation requested by the Administrative Agent, each bank, financial institution or other
entity committing to be a new Revolving Lender or Incremental Lender shall become a Lender for all purposes and to the same extent as if originally a party hereto and shall be bound by and entitled to the benefits of this Agreement and the other
Credit Documents, and shall benefit equally and ratably from the Guarantees and security interests (if applicable) created by the Security Documents, if any; provided that any Lender offered or approached to provide all or a portion of any Increased
Revolver Commitment may elect or decline, in its sole discretion, to provide such Increased Revolver Commitments. </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE III </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>REPRESENTATIONS AND WARRANTIES </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">To induce the Lenders to enter into this Agreement and to make Loans and to issue, extend, renew or participate in Letters of Credit, in each
case as herein provided for, the Credit Parties hereby represent and warrant to the Administrative Agent and to each Lender that: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.1</B> <B><U>Financial Condition</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) (i)&nbsp;The audited Consolidated financial statements of the<B> </B>Borrower and its Consolidated Subsidiaries for the fiscal years ended
December&nbsp;31, 2014, 2015 and 2016 set forth in the Borrower&#146;s annual report on Form <FONT STYLE="white-space:nowrap">10-K</FONT> for the fiscal year ended December&nbsp;31, 2016 and (ii)&nbsp;the unaudited Consolidated financial statements
of the Borrower and its Consolidated Subsidiaries for the <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">year-to-date</FONT></FONT> period ended on June&nbsp;30, 2017 set forth in the Borrower&#146;s quarterly report on Form <FONT
STYLE="white-space:nowrap">10-Q</FONT> for the period ended June&nbsp;30, 2017: </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">51 </P>

</DIV></Center>


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


<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">(A) were prepared in accordance with GAAP consistently applied throughout
the periods covered thereby, except as otherwise expressly noted therein; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(B) fairly present in all material respects the
financial condition of the Borrower and its Consolidated Subsidiaries as of the dates thereof (subject, in the case of the unaudited financial statements, to normal <FONT STYLE="white-space:nowrap">year-end</FONT> adjustments) and results of
operations for the period covered thereby; and </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(C) reflect in accordance with GAAP all material Indebtedness and other
liabilities, direct or contingent, of the Borrower and its Consolidated Subsidiaries, as applicable, as of the date thereof, including liabilities for taxes, material commitments and contingent obligations. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) The five-year projections of the Borrower and its Consolidated Subsidiaries delivered to the Lenders on or prior to the Closing Date have
been prepared in good faith based upon reasonable assumptions. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.2</B> <B><U>No Material Adverse
Effect</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Since December&nbsp;31, 2016 (and, in addition, after delivery of annual audited financial statements in accordance with
Section&nbsp;5.1(a), from the date of the most recently delivered annual audited financial statements), there has been no development or event which has had or could reasonably be expected to have a Material Adverse Effect. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.3</B> <B><U>Corporate Existence; Compliance with Law</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of the Credit Parties (a)&nbsp;is duly organized, validly existing and in good standing under the laws of the jurisdiction of its
incorporation, organization or formation, (b)&nbsp;except as could not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect, has the requisite power and authority and the legal right to own and operate all its
property, to lease the property it operates as lessee and to conduct the business in which it is currently engaged and has taken all actions necessary to maintain all rights, privileges, licenses and franchises necessary or required in the normal
conduct of its business, (c)&nbsp;is duly qualified to conduct business and in good standing under the laws of each other jurisdiction where its ownership, lease or operation of property or the conduct of its business requires such qualification
except to the extent that the failure to so qualify or be in good standing in any such other jurisdiction could not, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect and (d)&nbsp;is in compliance with all
Requirements of Law, organizational documents, government permits and government licenses except to the extent such <FONT STYLE="white-space:nowrap">non-compliance</FONT> could not, individually or in the aggregate, reasonably be expected to have a
Material Adverse Effect. No Credit Party has any oral or written operating agreement (or other similar document) which regulates the affairs of such Credit Party, the conduct of its business, establishes duties and/or governs the relations among any
member, manager and such Credit Party, other than such documents as have been previously delivered to the Administrative Agent. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.4</B> <B><U>Corporate Power; Authorization; Enforceable Obligations</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of the Credit Parties has full power and authority and the legal right to make, deliver and perform the Credit Documents to which it is
party and has taken all necessary limited liability company, partnership or corporate action to authorize the execution, delivery and performance by it of the Credit Documents to which it is party. Each Credit Document to which it is a party has
been duly executed and delivered on behalf of each Credit Party. Each Credit Document to which it is a party constitutes a legal, valid and binding obligation of each Credit Party, enforceable against such Credit Party in accordance with its terms,
except as enforceability may be limited by applicable bankruptcy, insolvency, reorganization, moratorium or other laws affecting the enforcement of creditors&#146; rights generally and by general equitable principles (whether enforcement is sought
by proceedings in equity or at law). </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">52 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;3.5</B> <B><U>No Legal Bar; No Default</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The execution, delivery and performance by each Credit Party of the Credit Documents to which such Credit Party is a party, the borrowings
thereunder and the use of the proceeds of the Loans (a)&nbsp;will not violate in any material respect any Requirement of Law (except those as to which waivers or consents have been obtained), (b)&nbsp;will not conflict with, result in a breach of or
constitute a default under (i)&nbsp;the articles of incorporation, bylaws, articles of organization, operating agreement or other organization documents of the Credit Parties or (ii)&nbsp;any Material Contract to which such Person is a party or by
which any of its properties may be bound or any material approval or material consent from any Governmental Authority relating to such Person (except those as to which waivers or consents have been obtained) which conflict, breach or default in any
such case in this clause (ii)&nbsp;could reasonably be expected to have a Material Adverse Effect, and (c)&nbsp;will not result in, or require, the creation or imposition of any Lien on any Credit Party&#146;s properties or revenues pursuant to any
Requirement of Law, the articles of incorporation, bylaws, articles of organization, operating agreement or other organization documents of such Credit Party or Contractual Obligation other than the Liens arising under or contemplated in connection
with the Credit Documents or Permitted Liens. No Credit Party is in default under or with respect to any of its Material Contracts in any material respect. No Default or Event of Default has occurred and is continuing. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.6</B> <B><U>No Material Litigation</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">No litigation, investigation, claim, criminal prosecution, civil investigative demand, imposition of criminal or civil fines and penalties, or
any other proceeding of or before any arbitrator or Governmental Authority is pending or, to the actual knowledge of the Responsible Officers of the Borrower, threatened (in writing) by or against any Credit Party or any of its Subsidiaries or
against any of its or their respective properties or revenues (a)&nbsp;with respect to the Credit Documents or any Extension of Credit or any of the transactions contemplated hereby, or (b)&nbsp;which, individually or in the aggregate, could
reasonably be expected to have a Material Adverse Effect. No permanent injunction, temporary restraining order or similar decree has been issued against any Credit Party or any of its Subsidiaries which, individually or in the aggregate, could
reasonably be expected to have a Material Adverse Effect. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section&nbsp;3.7 <U>Investment Company Act; etc.</U> </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">No Credit Party is an &#147;investment company,&#148; or a company &#147;controlled&#148; by an &#147;investment company,&#148; within the
meaning of the Investment Company Act of 1940, as amended. No Credit Party is subject to regulation under the Federal Power Act, the Interstate Commerce Act, the Public Utility Holding Company Act of 2005 or any federal or state statute or
regulation limiting its ability to incur the Credit Party Obligations. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.8</B> <B><U>Margin
Regulations</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">No part of the proceeds of any Extension of Credit hereunder will be used directly or indirectly for any purpose that
violates, or that would require any Lender to make any filings in accordance with, the provisions of Regulation T, U or X of the Board of Governors of the Federal Reserve System as now and from time to time hereafter in effect. The Credit Parties
and their Subsidiaries (a)&nbsp;are not engaged, principally or as one of their important activities, in the business of extending credit for the purpose of &#147;purchasing&#148; or &#147;carrying&#148; &#147;margin stock&#148; within the
respective meanings of each of such terms under Regulation U and (b)&nbsp;taken as a group do not own &#147;margin stock&#148; except as identified in the financial statements referred to in Section&nbsp;3.1 or delivered pursuant to Section&nbsp;5.1
and the aggregate value of all &#147;margin stock&#148; owned by the Credit Parties and their Subsidiaries taken as a group does not exceed 25% of the value of their assets. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.9</B> <B><U>ERISA</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Except as could not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Neither a Reportable Event nor an &#147;accumulated funding deficiency&#148; (within the meaning of Section&nbsp;412 of the
Code or Section&nbsp;302 of ERISA) has occurred during the <FONT STYLE="white-space:nowrap">five-year</FONT> period prior to the date on which this representation is made or deemed made with respect to any Plan, and each Plan has complied in all
material respects with the applicable provisions of ERISA and the Code. </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">53 </P>

</DIV></Center>


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


<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">(b) No termination of a Single Employer Plan has occurred resulting in any
liability that has remained underfunded, and no Lien in favor of the PBGC or a Plan has arisen, during such <FONT STYLE="white-space:nowrap">five-year</FONT> period. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) The present value of all accrued benefits under each Single Employer Plan (based on those assumptions used to fund such
Plans) did not, as of the last annual valuation date prior to the date on which this representation is made or deemed made, exceed the value of the assets of such Plan allocable to such accrued benefits. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) Neither any Credit Party nor any Commonly Controlled Entity is currently subject to any liability for a complete or partial
withdrawal from a Multiemployer Plan. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.10</B> <B><U>Environmental Matters</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Except as could not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) To the actual knowledge of the Responsible Officers of the Borrower, the facilities and properties owned, leased or
operated by the Credit Parties or any of their Subsidiaries (the &#147;<U>Properties</U>&#148;) do not contain any Materials of Environmental Concern in amounts or concentrations which (i)&nbsp;constitute a violation of, or (ii)&nbsp;could give rise
to liability on behalf of any Credit Party under, any Environmental Law. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) To the actual knowledge of the Responsible
Officers of the Borrower, the Properties and all operations of the Credit Parties and/or their Subsidiaries at the Properties are in compliance, and have in the last five years been in compliance, with all applicable Environmental Laws, and there is
no contamination at, under or about the Properties or violation of any Environmental Law with respect to the Properties or the business operated by the Credit Parties or any of their Subsidiaries (the &#147;<U>Business</U>&#148;). </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) Neither the Credit Parties nor their Subsidiaries have received any written or actual notice of violation, alleged
violation, <FONT STYLE="white-space:nowrap">non-compliance,</FONT> liability or potential liability on behalf of any Credit Party with respect to environmental matters or Environmental Laws regarding any of the Properties or the Business, nor do the
Responsible Officers of the Borrower have actual knowledge or reason to believe that any such notice will be received or is being threatened. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) To the actual knowledge of the Responsible Officers of the Borrower, Materials of Environmental Concern have not been
transported or disposed of from the Properties in violation of, or in a manner or to a location that could give rise to liability on behalf of any Credit Party under any Environmental Law, and no Materials of Environmental Concern have been
generated, treated, stored or disposed of at, on or under any of the Properties in violation of, or in a manner that could give rise to liability on behalf of any Credit Party under, any applicable Environmental Law. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) No judicial proceeding or governmental or administrative action is pending or, to the actual knowledge of the Responsible
Officers of the Borrower, threatened, under any Environmental Law to which any Credit Party or any Subsidiary is or will be named as a party with respect to the Properties or the Business, nor are there any consent decrees or other decrees, consent
orders, administrative orders or other orders, or other administrative or judicial requirements outstanding under any Environmental Law with respect to the Properties or the Business. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) To the actual knowledge of the Responsible Officers of the Borrower, there has been no release or threat of release of
Materials of Environmental Concern at or from the Properties, or arising from or related to the operations of any Credit Party or any Subsidiary in connection with the Properties or otherwise in connection with the Business, in violation of or in
amounts or in a manner that could give rise to liability on behalf of any Credit Party under Environmental Laws. Notwithstanding anything set forth in this Section&nbsp;3.10, the term &#147;Properties&#148; shall not include any hospital or other
medical facility at which a Credit Party or its Subsidiaries provides services unless such facility is owned or leased by a Credit Party or its Subsidiaries. </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">54 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;3.11</B> <B><U>Use of Proceeds</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The proceeds of the Extensions of Credit shall be used by the Borrower solely (a)&nbsp;to&nbsp;refinance the Existing Credit Agreement,
(b)&nbsp;to pay any costs, fees and expenses associated with this Agreement on the Closing Date and (c)&nbsp;for working capital and other general corporate purposes of the Credit Parties and their Subsidiaries (including, without limitation,
Permitted Acquisitions and Restricted Payments). </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.12</B> <B><U>Subsidiaries; Joint Ventures;
Partnerships</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Set forth on <U>Schedule 3.12</U> is (a)&nbsp;the exact legal name of each Credit Party, the state of incorporation
or organization, the chief executive office, the principal place of business, the jurisdictions in which the Credit Parties are qualified to do business, the federal tax identification number and organization identification number of each of the
Credit Parties as of the Closing Date (and for the four&nbsp;(4) months prior to the Closing Date) and (b)&nbsp;a complete and accurate list of all Subsidiaries, joint ventures and partnerships of the Credit Parties as of the Closing Date and as of
the last date such Schedule was required to be updated in accordance with Section&nbsp;5.2. Information on the attached Schedule includes the following: (a)&nbsp;the percentage of outstanding shares of each class of Equity Interest owned by the
Credit Parties and their Subsidiaries and (b)&nbsp;the name and address of each Equity Holder that owns, directly or indirectly, Equity Interests in any Subsidiary of the Borrower. The outstanding Equity Interest and other equity interests of all
such Subsidiaries is validly issued, fully paid and <FONT STYLE="white-space:nowrap">non-assessable</FONT> and is owned free and clear of all Liens. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.13</B> <B><U>Ownership</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Except as could not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Each of the Credit Parties and its Subsidiaries is the owner of, and has good and marketable title to or a valid leasehold
interest in, all of its respective assets, which, together with assets leased or licensed by the Credit Parties and their Subsidiaries, represents all assets in the aggregate material to the conduct of the business of the Credit Parties and their
Subsidiaries, and (after giving effect to the Transactions) none of such assets is subject to any Lien other than Permitted Liens. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Each Credit Party and its Subsidiaries enjoys peaceful and undisturbed possession under all of its leases and all such
leases are valid and subsisting and in full force and effect. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.14</B> <B><U>Taxes</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of the Credit Parties and its Subsidiaries has filed, or caused to be filed, all income Tax returns and all other material Tax returns
(federal, state, local and foreign) required to be filed and paid (a)&nbsp;all amounts of taxes shown thereon to be due (including interest and penalties) and (b)&nbsp;all other material Taxes, fees, assessments and other governmental charges
(including mortgage recording Taxes, documentary stamp Taxes and intangibles Taxes) owing by it, except for such Taxes (i)&nbsp;that are not yet delinquent or (ii)&nbsp;that are being contested in good faith and by proper proceedings, and against
which adequate reserves are being maintained in accordance with GAAP. Except as could not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect, none of the Credit Parties or their Subsidiaries is aware as of
the Closing Date of any proposed Tax assessments against it or any of its Subsidiaries. </P> <P STYLE="font-size:12pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</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">55 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;3.15</B> <B><U>Solvency</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">After giving effect to the Transactions, (a)&nbsp;the Credit Parties taken as a whole are solvent and are able to pay their debts and other
liabilities, contingent obligations and other commitments as they mature in the normal course of business, and (b)&nbsp;the fair saleable value of the Credit Parties&#146; assets taken as a whole, measured on a going concern basis, exceeds all
probable liabilities, including those to be incurred pursuant to this Agreement. After giving effect to the Transactions, none of the Credit Parties (i)&nbsp;has unreasonably small capital in relation to the business in which it is or proposes to be
engaged or (ii)&nbsp;has incurred, or believes that it will incur debts beyond its ability to pay such debts as they become due. In executing the Credit Documents and consummating the Transactions, none of the Credit Parties intends to hinder, delay
or defraud either present or future creditors or other Persons to which one or more of the Credit Parties is or will become indebted. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.16</B> <B><U>No Burdensome Restrictions</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">None of the Credit Parties or their Subsidiaries is a party to any agreement or instrument or subject to any other obligation or any charter or
corporate restriction or any provision of any applicable law, rule or regulation which, individually or in the aggregate, could reasonably be expected to have a Material Adverse Effect. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.17</B> <B><U>Brokers&#146; Fees</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">None of the Credit Parties or their Subsidiaries has any obligation to any Person in respect of any finder&#146;s, broker&#146;s, investment
banking or other similar fee in connection with any of the transactions contemplated under the Credit Documents other than the closing and other fees payable pursuant to this Agreement and as set forth in the Fee Letters. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.18</B> <B><U>Labor Matters</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Except as could not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect, there are no collective
bargaining agreements or Multiemployer Plans covering the employees of the Credit Parties or any of their Subsidiaries as of the Closing Date, other than as set forth in <U>Schedule 3.18</U> hereto, and none of the Credit Parties or their
Subsidiaries (a)&nbsp;has suffered any strikes, walkouts, work stoppages or other material labor difficulty within the last five years, other than as set forth in <U>Schedule 3.18</U> hereto, or (b)&nbsp;has knowledge of any potential or pending
strike, walkout or work stoppage. Other than as set forth on <U>Schedule 3.18</U>, no unfair labor practice complaint is pending against any Credit Party or any of its Subsidiaries that could reasonably be expected, individually or in the aggregate,
to have a Material Adverse Effect. Except as could not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect, there are no strikes, walkouts, work stoppages or other material labor difficulty pending or
threatened against any Credit Party. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.19</B> <B><U>Accuracy and Completeness of Information</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">All written factual information (other than (i)&nbsp;any projections, (ii)&nbsp;other forward-looking information and (iii)&nbsp;information of
a general economic or industry nature) concerning any Credit Party and its Subsidiaries and the transactions contemplated by the Credit Documents heretofore, contemporaneously or hereafter furnished by or on behalf of any Credit Party or any of its
Subsidiaries to the Administrative Agent, the Arrangers or any Lender for purposes of or in connection with this Agreement or any other Credit Document, or any transaction contemplated hereby or thereby, when taken as a whole, is or, in the case of
such information furnished after the date hereof, will be, true and accurate in all material respects and not incomplete by omitting to state any material fact necessary to make such information in light of the circumstances in which such
information is provided not materially misleading, in each case, after giving effect to all supplements and updates thereto from time to time prior to the date this representation is made; <U>provided</U>, that with respect to projected financial
information, the Credit Parties represent only that such information was prepared in good faith on assumptions believed to be reasonable at the time made and are not to be viewed as facts and are subject to significant uncertainties and
contingencies many of which are beyond your control, that no assurance can be given that any projections will be realized and actual results may vary materially from the projected financial information. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.20</B> <B><U>Material Contracts</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each Material Contract is, and after giving effect to the Transactions will be, in full force and effect in accordance with the terms thereof.
</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">56 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;3.21</B> <B><U>Insurance</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The insurance coverage of the Credit Parties and their Subsidiaries is outlined as to carrier, policy number, expiration date, type and amount
on <U>Schedule</U><U></U><U>&nbsp;3.21</U> as of the Closing Date and as of the last date such Schedule was required to be updated in accordance with Section&nbsp;5.2 and such insurance coverage complies with the requirements set forth in
Section&nbsp;5.5(b). </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.22</B> <B><U>Intellectual Property Matters</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Except as could not reasonably be expected to have a Material Adverse Effect, the Credit Parties and their Subsidiaries own, or possess the
right to use, all of the Intellectual Property, trade names, franchises, licenses and other intellectual property rights (collectively, &#147;<U>IP Rights</U>&#148;) that are reasonably necessary for the operation of their respective businesses as
now conducted by them in all material respects, without infringement of the rights of any other Person. To the actual knowledge of the Responsible Officers of the Borrower, no slogan or other advertising device, product, process, method, substance,
part or other material now employed, or now contemplated to be employed, by any Credit Party or any Subsidiary infringes in any material respect upon any rights held by any other Person. No event has occurred which permits, or after the notice or
lapse of time or both would permit, the revocation or termination of any such license, franchise or other right or which affects the rights of any of the Credit Parties or any of their Subsidiaries thereunder which, individually or in the aggregate,
could reasonably be expected to have a Material Adverse Effect. No claim or litigation regarding any of the foregoing is pending or, to the best knowledge of each Credit Party, threatened (in writing), which, individually or in the aggregate, could
reasonably be expected to have a Material Adverse Effect. No representation is made in this Section&nbsp;3.22 regarding &#147;shrink wrap&#148; or &#147;off the shelf&#148; software, or software embedded in commercially available electronic
hardware. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.23</B> <B><U>Classification of Senior Indebtedness</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Party Obligations constitute &#147;Senior Indebtedness,&#148; &#147;Designated Senior Indebtedness&#148; or any similar designation
under and as defined in any agreement governing any Subordinated Debt and the subordination provisions set forth in each such agreement are legally valid and enforceable against the parties thereto. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.24</B> <B><U>Anti-Corruption Laws and Sanctions</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Borrower has implemented and maintains in effect policies and procedures designed to ensure compliance by the Borrower, its Subsidiaries
and their respective directors, officers, employees and agents with Anti-Corruption Laws and applicable Sanctions, and the Borrower, its Subsidiaries and their respective officers and employees and to the knowledge of the Borrower its directors and
agents, are in compliance with Anti-Corruption Laws and applicable Sanctions in all material respects and are not knowingly engaged in any activity that would reasonably be expected to result in the Borrower being designated as a Sanctioned Person.
None of (a)&nbsp;the Borrower, any Subsidiary or any of their respective directors, officers or employees, or (b)&nbsp;to the knowledge of the Borrower any agent of the Borrower or any Subsidiary that will act in any capacity in connection with or
benefit from the credit facility established hereby, is a Sanctioned Person. No Loan or Letter of Credit, use of proceeds or other transaction contemplated by the Credit Agreement will violate Anti-Corruption Laws or applicable Sanctions. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.25</B> <B><U>Consent; Governmental Authorizations</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">No approval, consent or authorization of, filing with, notice to or other act by or in respect of, any Governmental Authority or any other
Person (including any Equity Holder) is required in connection with acceptance of Extensions of Credit by the Borrower or the making of the Guaranty hereunder or with the execution, delivery or performance of any Credit Document by the Credit
Parties (other than those which have been obtained) or with the validity or enforceability of any Credit Document against the Credit Parties. </P> <P STYLE="font-size:12pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</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">57 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;3.26</B> <B><U>Healthcare Representations and
Warranties</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Reports; Audits</U>. Except for matters that could not, individually or in the aggregate, reasonably be
expected to have a Material Adverse Effect: (i)&nbsp;as applicable, the Credit Parties have timely filed or caused to be timely filed, all cost reports and other reports of every kind whatsoever required by law or by written contracts or otherwise
to have been filed or made with respect to such Credit Party&#146;s business and operations; (ii)&nbsp;there are no claims, actions or appeals pending (and each Credit Party has not filed any claims or reports which should result in any such claims,
actions or appeals) before any commission, board or agency, including, without limitation, any intermediary or carrier, the Provider Reimbursement Review Board or the Administrator of CMS, with respect to cost reports or claims filed by any Credit
Party under any Government Reimbursement Program, or any disallowance by any commission, board or agency in connection with any audit of such cost reports or claims; and (iii)&nbsp;no validation review or program integrity review related to any
Credit Party, or the consummation of the transactions contemplated in the Credit Documents, have been conducted by any commission, board or agency in connection with any Government Reimbursement Program, and to the actual knowledge of the
Responsible Officers of the Borrower, no such reviews are scheduled, pending or threatened against or affecting any Credit Party, any Credit Party&#146;s employees or agents, or the consummation of the transactions contemplated hereby. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Compliance With Health Care Laws</U>. Each Credit Party is in compliance with all applicable Healthcare Laws except where the failure
to comply, individually or in the aggregate, could not reasonably be expected to have a Material Adverse Effect. To the extent applicable to each Credit Party, each Credit Party has maintained in all material respects all records required to be
maintained by the Joint Commission, Government Reimbursement Programs, and the Healthcare Laws, and, to the actual knowledge of the Responsible Officers of the Borrower, there are no presently existing circumstances which could reasonably be
expected to constitute or result in a violation of any Healthcare Law, in each case that could, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect. To the actual knowledge of the Responsible Officers of the
Borrower, no Credit Party is currently subject to any federal, state, local governmental or private payor civil or criminal inspections, investigations, inquiries or audits involving and/or related to its activities or compliance with Healthcare
Laws, except for audits and inspections that could not, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect. Except as could not reasonably be expected to have a Material Adverse Effect, no Credit Party:
(i)&nbsp;has had a civil monetary penalty assessed against it pursuant to 42&nbsp;U.S.C. <FONT STYLE="white-space:nowrap">&#167;1320a-7a;</FONT> (ii)&nbsp;has been excluded from participation in a Federal Health Care Program (as that term is defined
in 42&nbsp;U.S.C. <FONT STYLE="white-space:nowrap">&#167;1320a-7b);</FONT> (iii)&nbsp;has been convicted (as that term is defined in 42&nbsp;C.F.R. &#167;1001.2) of any of those offenses described in 42&nbsp;U.S.C.
<FONT STYLE="white-space:nowrap">&#167;1320a-7b</FONT> or 18&nbsp;U.S.C. &#167;&#167;669, 1035, 1347, 1518; or (iv)&nbsp;to the actual knowledge of the Responsible Officers of the Borrower, is involved or named in a U.S. Attorney complaint made or
any other action taken pursuant to the False Claims Act under 31&nbsp;U.S.C. <FONT STYLE="white-space:nowrap">&#167;&#167;3729-3731</FONT> or qui tam action brought pursuant to 31&nbsp;U.S.C. &#167;3729 <I>et seq</I>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Licenses, Permits, and Certifications</U>. Each Credit Party has, and to the actual knowledge of one or more Responsible Officers of
the Borrower, each Equity Holder has, such permits, licenses, franchises, certificates and other approvals or authorizations of Governmental Authorities as are necessary under applicable law or regulations to own its properties and to conduct its
business and to submit claims for and receive reimbursement under all applicable Government Reimbursement Programs and Private Payor Arrangements (including without limitation such permits as are required under Healthcare Laws and under such HMO or
similar licensure laws and such insurance laws and regulations, as are applicable thereto) other than such failures as could not reasonably be expected to have a Material Adverse Effect. Each Credit Party has, and to the actual knowledge of one or
more Responsible Officers of the Borrower, each Equity Holder has, all Medicare, Medicaid and related agency supplier billing number(s) and related documentation necessary for it to receive reimbursement claims under all applicable Government
Reimbursement Programs for any medical services or supplies furnished by any Credit Party in any jurisdiction where any Credit Party conducts business other than such failures as could not reasonably be expected to have a Material Adverse Effect. No
Credit Party (and, to the actual knowledge of one or more Responsible Officer of the Borrower, no Equity Holder) is currently subject to, suspension, revocation, renewal or denial of any applicable certification, provider or supplier billing
number(s), or any participation agreement(s) under any applicable Government Reimbursement Program which could reasonably be expected to cause a Material Adverse Effect. There currently exist no restrictions, deficiencies, required plans of
corrective action or other such remedial measures with respect to any certifications, accreditations or licensures (whether under any Government Reimbursement Program, or Healthcare Law) other than restrictions, deficiencies, required plans of
corrective action or other remedial measures that could not, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect. </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">58 </P>

</DIV></Center>


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


<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">(d) <U>Participation Agreements</U>. To the actual knowledge of the Responsible Officers of
the Borrower, there is no threatened termination of any participation agreements under any Private Payor Arrangements to which any Credit Party is a party and which termination would reasonably be expected to have a Material Adverse Effect. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) <U>HIPAA Compliance</U>. To the actual knowledge of the Responsible Officers of the Borrower, no Credit Party is the subject of any civil
or criminal penalty, process, claim, action or proceeding, or any administrative or other regulatory review, survey, process or proceeding alleging a violation of HIPAA that could, individually or in the aggregate, reasonably be expected to have a
Material Adverse Effect. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) <U>Equity Holder Compliance</U>. Other than where failure to do so could not reasonably be expected to have
a Material Adverse Effect, to the actual knowledge of one or more Responsible Officers of the Borrower, each Equity Holder is duly licensed (where license is required) by each state or state agency or commission, or any other Governmental Authority
having jurisdiction over the provision of such services by such Person in the locations in which the Equity Holder and the applicable Subsidiaries conduct business, required to enable such Person to provide the professional services provided by such
Person and otherwise as is necessary to enable the Equity Holder and each such applicable Subsidiary to operate as currently operated and as presently contemplated to be operated. To the actual knowledge of the Borrower&#146;s Responsible Officers,
all such required licenses are in full force and effect on the date hereof and have not been revoked or suspended or otherwise limited in any material respect. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.27</B> <U>Security Interests</U>. At any time following the Collateral Event, the Security Documents are
effective to create in favor of the Administrative Agent, for the ratable benefit of the Lenders and the Bank Product Providers, legal, valid and enforceable first priority Liens (subject to Permitted Liens) on, and security interests in, the
Collateral and, when (a)&nbsp;each (i) financing statement on form <FONT STYLE="white-space:nowrap">UCC-1</FONT> made pursuant to the Security Documents is filed in the appropriate office as required by the Uniform Commercial Code,
(ii)&nbsp;Security Documents (or short form security agreement with respect to intellectual property) are filed with the United States Patent and Trademark Office and the United States Copyright Office, as applicable, and (iii)&nbsp;all other
appropriate filings or recordings are made in the appropriate offices as may be required under applicable law, and in each case, all filing and recording fees have been paid, and (b)&nbsp;upon the taking of possession, control or other action by the
Administrative Agent of such Collateral with respect to which a security interest may be perfected only by possession, control or other action, such security interests will constitute fully perfected Liens on, and security interests in, all right,
title and interest of the Credit Parties in such Collateral, in each case subject to no Liens other than Permitted Liens. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.28</B> <U>EEA Financial Institutions</U><B> </B>No Credit Party is an EEA Financial Institution. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;3.29</B> <U>ERISA</U> The Borrower represents and warrants as of the Closing Date that the Borrower is not and
will not be using &#147;plan assets&#148; (within the meaning of 29 CFR &#167; <FONT STYLE="white-space:nowrap">2510.3-101,</FONT> as modified by Section&nbsp;3(42) of ERISA) of one or more Benefit Plans in connection with the Loans, the Letters of
Credit or the Commitments. </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE IV </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>CONDITIONS PRECEDENT </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;4.1</B> <B><U>Conditions to Closing Date and Initial Revolving Loans</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">This Agreement shall become effective upon, and the obligation of each Lender to make the initial Extensions of Credit on the Closing Date is
subject to, the satisfaction, or waiver by the Administrative Agent, of the following conditions precedent: </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a)
<U>Execution of Credit Agreement; Credit Documents and Lender Consents</U>. The Administrative Agent shall have received (i)&nbsp;counterparts of this Agreement, executed by a duly authorized officer of each party hereto, (ii)&nbsp;counterparts of
any other Credit Document, executed by the duly authorized officers of the parties thereto and (iii)&nbsp;executed consents, in substantially the form of <U>Exhibit</U><U></U><U>&nbsp;4.1(a)</U>, from each Lender authorizing the Administrative Agent
to enter this Credit Agreement on their behalf. </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">59 </P>

</DIV></Center>


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


<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">(b) <U>Authority Documents</U>. The Administrative Agent shall have received
the following: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) <U>Articles of Incorporation/Charter Documents</U>. Original certified articles of incorporation or
other charter documents, as applicable, of each Credit Party certified (A)&nbsp;by an officer of such Credit Party (pursuant to an officer&#146;s certificate in substantially the form of <U>Exhibit 4.1(b)</U> attached hereto) as of the Closing Date
to be true and correct and in force and effect as of such date, and (B)&nbsp;with respect to the articles of incorporation of the Borrower, to be true and complete as of a recent date by the appropriate Governmental Authority of the State of
Florida. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) <U>Resolutions</U>. Copies of resolutions of the board of directors or comparable managing body of each
Credit Party approving and adopting the Credit Documents, the transactions contemplated therein and authorizing execution and delivery thereof, certified by an officer of such Credit Party (pursuant to an officer&#146;s certificate in substantially
the form of <U>Exhibit</U><U></U><U>&nbsp;4.1(b)</U> attached hereto) as of the Closing Date to be true and correct and in force and effect as of such date. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) <U>Bylaws/Operating Agreement</U>. A copy of the bylaws or comparable operating agreement of each Credit Party certified
by an officer of such Credit Party (pursuant to an officer&#146;s certificate in substantially the form of <U>Exhibit</U><U></U><U>&nbsp;4.1(b)</U> attached hereto) as of the Closing Date to be true and correct and in force and effect as of such
date. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iv) <U>Good Standing</U>. Copies of certificates of good standing, existence or its equivalent with respect to each
Credit Party certified as of a recent date by the appropriate Governmental Authorities of the state of incorporation or organization and each other state in which the failure to so qualify and be in good standing could reasonably be expected to have
a Material Adverse Effect; <U>provided</U> that any certificate of good standing set forth on <U>Schedule 5.12(e)</U> may instead be provided within the time period set forth in <U>Schedule 5.12(e)</U>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(v) <U>Incumbency</U>. An incumbency certificate of each Credit Party certified by an officer (pursuant to an officer&#146;s
certificate in substantially the form of <U>Exhibit</U><U></U><U>&nbsp;4.1(b)</U> attached hereto) to be true and correct as of the Closing Date. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(vi) <U>Florida Stamp Tax</U>. To the extent reasonably requested by the Administrative Agent, and in such case reasonably
satisfactory to the Administrative Agent, either (i)&nbsp;such affidavits relative to the execution and delivery of any Credit Document as required to support the determination that no Florida documentary stamp taxes are required to be paid ,or
(ii)&nbsp;evidence of payment by the Borrower of any Florida documentary stamp taxes applicable to the execution and delivery of the Credit Documents. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Legal Opinion of Counsel</U>. The Administrative Agent shall have received an opinion or opinions (including, if
requested by the Administrative Agent, local counsel opinions) of counsel for the Credit Parties, dated the Closing Date and addressed to the Administrative Agent and the Lenders, in form and substance acceptable to the Administrative Agent (which
shall include, without limitation, opinions with respect to the due organization and valid existence of each Credit Party and opinions as to the <FONT STYLE="white-space:nowrap">non-contravention</FONT> of the Credit Parties&#146; organizational
documents and Material Contracts); <U>provided</U> that the opinion of counsel set forth on <U>Schedule 5.12(e)</U> may instead be provided within the time period set forth in <U>Schedule 5.12(e)</U>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) <U>Liability, Casualty, Property and Business Interruption Insurance</U>. The Administrative Agent shall have received
copies of insurance policies or certificates and endorsements of insurance evidencing general liability, casualty, property and business interruption insurance. The Administrative Agent shall be named as additional insured on behalf of the Lenders
with respect to any such insurance providing general liability coverage, and the Credit Parties will use their commercially reasonable efforts to have each provider of any such insurance agree, by endorsement upon the policy or policies issued by it
or by independent instruments to be furnished to the Administrative Agent, that it will give the Administrative Agent thirty&nbsp;(30) days&#146; (or ten (10)&nbsp;days in the case of nonpayment) prior written notice before any such policy or
policies shall be materially altered or cancelled. </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">60 </P>

</DIV></Center>


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


<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">(e) <U>Solvency Certificate</U>. The Administrative Agent shall have
received an officer&#146;s certificate prepared by the chief financial officer of the Borrower as to the financial condition, solvency and related matters of the Credit Parties and their Subsidiaries, after giving effect to the Transactions and the
initial borrowings under the Credit Documents, in substantially the form of <U>Exhibit</U><U></U><U>&nbsp;4.1(e)</U> hereto. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) <U>Account Designation Notice</U>. The Administrative Agent shall have received the executed Account Designation Notice in
the form of <U>Exhibit 1.1(a)</U> hereto. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(g) <U>Notice of Borrowing</U>. The Administrative Agent shall have received a
Notice of Borrowing with respect to the Loans to be made on the Closing Date. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(h) <U>Consents</U>. The Administrative
Agent shall have received evidence that any applicable boards of directors, governmental, shareholder and material third party consents and approvals necessary in connection with the Transactions have been obtained and all applicable waiting periods
have expired without any action being taken by any authority that could restrain, prevent or impose any material adverse conditions on such transactions or that could seek or threaten any of the foregoing. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) <U>Compliance with Laws</U>. The Transactions contemplated hereby shall be in compliance in all material respects with all
applicable laws and regulations (including all applicable securities and banking laws, rules and regulations). </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(j)
<U>Bankruptcy</U>. There shall be no bankruptcy or insolvency proceedings pending with respect to any Credit Party or any Subsidiary thereof. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(k) <U>Existing Indebtedness of the Credit Parties</U>. All of the existing Indebtedness for borrowed money of the Credit
Parties and their Subsidiaries (other than Indebtedness permitted to exist pursuant to Section&nbsp;6.1) shall be repaid in full and all security interests related thereto (other than Permitted Liens) shall be terminated on or prior to the Closing
Date. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(l) <U>Financial Statements</U>. The Administrative Agent and the Lenders shall have received copies of the
financial statements referred to in Section&nbsp;3.1, each in form and substance satisfactory to each of them. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(m) <U>No
Material Adverse Change</U>. Since December&nbsp;31, 2016 there shall have been no material adverse change in the business, properties, prospects, operations or condition (financial or otherwise) of the Credit Parties<B> </B>or any of their
respective Subsidiaries. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(n) <U>Financial Condition Certificate</U>. The Administrative Agent shall have received a
certificate or certificates executed by a Responsible Officer of the Borrower as of the Closing Date, substantially in the form of <U>Exhibit 4.1(n)</U> stating that (i)&nbsp;to the actual knowledge of the Responsible Officers of the Borrower, there
does not exist any pending or ongoing, action, suit, investigation, litigation or proceeding in any court or before any other Governmental Authority (A)&nbsp;affecting this Agreement or the other Credit Documents, that has not been settled,
dismissed, vacated, discharged or terminated prior to the Closing Date or (B)&nbsp;that purports to affect any Credit Party or any of its Subsidiaries, or any transaction contemplated by the Credit Documents, which action, suit, investigation,
litigation or proceeding could reasonably be expected to have a Material Adverse Effect, that has not been settled, dismissed, vacated, discharged or terminated prior to the Closing Date, (ii)&nbsp;immediately after giving effect to this Agreement,
the other Credit Documents, and all the Transactions contemplated to occur on such date, (A)&nbsp;no Default or Event of Default exists, (B)&nbsp;all representations and warranties contained herein and in the other Credit Documents (1)&nbsp;with
respect to representations and warranties that contain a materiality qualification, are true and correct and (2)&nbsp;with respect to representations and warranties that do not contain a materiality qualification, are true and correct in all
material respects and (C)&nbsp;the Credit Parties are in pro forma </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">61 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
compliance with each of the initial financial covenants set forth in Section&nbsp;5.9 (as evidenced through detailed calculations of such financial covenants on a schedule to such certificate) as
of the last day of the quarter ending at least twenty (20)&nbsp;days<B> </B>preceding the Closing Date and (iii)&nbsp;each of the other conditions precedent in Section&nbsp;4.1 have been satisfied, except to the extent the satisfaction of any such
condition is subject to the reasonable judgment of the Administrative Agent or any Lender. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(o) <U>Patriot Act
Certificate</U>. At least three (3)&nbsp;Business Days prior to the Closing Date, to the extent requested by the Administrative Agent at least ten (10)&nbsp;Business Days prior to the Closing Date, the Administrative Agent shall have received a
certificate satisfactory thereto, substantially in the form of Exhibit 4.1(o), for benefit of itself and the Lenders, provided by the Borrower that sets forth information required by the Patriot Act including, without limitation, the identity of the
Credit Parties, the name and address of the Credit Parties and other information that will allow the Administrative Agent or any Lender, as applicable, to identify the Credit Parties in accordance with the Patriot Act. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(p) <U>Fees and Expenses</U>. The Administrative Agent and the Lenders shall have received all fees and expenses, if any, owing
pursuant to any Fee Letter, the Commitment Letter and Section&nbsp;2.5. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(q) <U>Additional Matters</U>. All other documents
and legal matters in connection with the transactions contemplated by this Agreement shall be reasonably satisfactory in form and substance to the Administrative Agent and its counsel. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Without limiting the generality of the provisions of Section&nbsp;8.4, for purposes of determining compliance with the conditions specified in
this Section&nbsp;4.1, each Lender that has signed this Agreement or a Lender Consent shall be deemed to have consented to, approved or accepted or to be satisfied with, each document or other matter required thereunder to be consented to or
approved by or acceptable or satisfactory to a Lender unless the Administrative Agent shall have received notice from such Lender prior to the proposed Closing Date specifying its objection thereto. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;4.2</B> <B><U>Conditions to All Extensions of Credit</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The obligation of each Lender to make any Extension of Credit hereunder is subject to the satisfaction of the following conditions precedent on
the date of making such Extension of Credit: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Representations and Warranties</U>. The representations and warranties
made by the Credit Parties herein and which are contained in any certificate furnished at any time under or in connection herewith shall (i)&nbsp;with respect to representations and warranties that contain a materiality qualification, be true and
correct and (ii)&nbsp;with respect to representations and warranties that do not contain a materiality qualification, be true and correct in all material respects, in each case on and as of the date of such Extension of Credit as if made on and as
of such date except for any representation or warranty made as of an earlier date, which representation and warranty shall remain true and correct (subject to the applicable materiality threshold in the preceding clauses (i)&nbsp;or (ii)) as of such
earlier date. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>No Default or Event of Default</U>. No Default or Event of Default shall have occurred and be
continuing on such date or after giving effect to the Extension of Credit to be made on such date unless such Default or Event of Default shall have been waived in accordance with this Agreement. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Compliance with Commitments</U>. Immediately after giving effect to the making of any such Extension of Credit (and the
application of the proceeds thereof), (i)&nbsp;the sum of the aggregate principal amount of outstanding Revolving Loans <U>plus</U> the aggregate principal amount of outstanding LOC Obligations shall not exceed the Revolving Committed Amount then in
effect, and (ii)&nbsp;the aggregate principal amount of the outstanding LOC Obligations shall not exceed the LOC Committed Amount. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) <U>Additional Conditions to Revolving Loans</U>. If a Revolving Loan is requested, all conditions set forth in
Section&nbsp;2.1 shall have been satisfied. </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">62 </P>

</DIV></Center>


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


<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">(e) <U>Incremental Commitment</U>. If an Incremental Commitment is
requested, all conditions set forth in Section&nbsp;2.22 shall have been satisfied. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) <U>Additional Conditions to
Letters of Credit</U>. If the issuance of a Letter of Credit is requested, (i)&nbsp;all conditions set forth in Section&nbsp;2.3 shall have been satisfied and (ii)&nbsp;there shall exist no Lender that is a Defaulting Lender unless the Issuing
Lenders have entered into reasonably satisfactory arrangements with the Borrower or such Defaulting Lender to eliminate the Issuing Lenders&#146; risk with respect to such Defaulting Lender&#146;s LOC Obligations. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each request for an Extension of Credit and each acceptance by the Borrower of any such Extension of Credit shall be deemed to constitute
representations and warranties by the Credit Parties as of the date of such Extension of Credit that the conditions set forth above in paragraphs (a)&nbsp;through (f), as applicable, have been satisfied. </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE V </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>AFFIRMATIVE
COVENANTS </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of the Credit Parties hereby covenants and agrees that on the Closing Date, and thereafter (a)&nbsp;for so long as
this Agreement is in effect, (b)&nbsp;until the Commitments have terminated, and (c)&nbsp;until no Note remains outstanding and unpaid and the Credit Party Obligations and all other amounts owing to the Administrative Agent or any Lender hereunder
are paid in full, such Credit Party shall, and shall cause each of their Subsidiaries, to: </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.1</B>
<B><U>Financial Statements</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Furnish to the Administrative Agent for prompt further distribution to each Lender: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Annual Financial Statements</U>. As soon as available and in any event no later than the fifth Business Day following
the earlier of (i)&nbsp;to the extent applicable, the date the Borrower is required by the SEC to file its Form <FONT STYLE="white-space:nowrap">10-K</FONT> for each fiscal year of the Borrower and (ii)&nbsp;ninety (90)&nbsp;days after the end of
each fiscal year of the Borrower, a copy of the Consolidated<B> </B>balance sheet of the Borrower and its Consolidated Subsidiaries as at the end of such fiscal year and the related Consolidated statements of income and retained earnings and of cash
flows of the Borrower and its Consolidated Subsidiaries for such year, which shall be audited by an independent registered certified public accounting firm of nationally recognized standing reasonably acceptable to the Administrative Agent, setting
forth in each case in comparative form the figures for the previous year, reported on without a &#147;going concern&#148; or like qualification or exception, or qualification indicating that the scope of the audit was inadequate to permit such
independent certified public accountants to certify such financial statements without such qualification; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Quarterly
Financial Statements</U>. As soon as available and in any event no later than the fifth Business Day following the earlier of (i)&nbsp;to the extent applicable, the date the Borrower is required by the SEC to file its Form <FONT
STYLE="white-space:nowrap">10-Q</FONT> for any fiscal quarter of the Borrower and (ii)&nbsp;forty-five (45)&nbsp;days after the end of each of the first three fiscal quarters of the Borrower, a copy of the Consolidated balance sheet of the
Borrower<B> </B>and its Consolidated Subsidiaries as at the end of such period and related Consolidated statements of income and retained earnings and of cash flows for the Borrower and its Consolidated Subsidiaries for such quarterly period and for
the portion of the fiscal year ending with such period, in each case setting forth in comparative form Consolidated figures for the corresponding period or periods of the preceding fiscal year (subject to normal recurring <FONT
STYLE="white-space:nowrap">year-end</FONT> audit adjustments);<I> </I>and </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Annual Operating Budget and Cash
Flow</U>. As soon as available, but in any event within forty-five (45)&nbsp;days after the end of each fiscal year (including the fiscal year ending December&nbsp;31, 2017), a copy of the detailed annual operating budget or plan including cash flow
projections of the Borrower and its Consolidated Subsidiaries for the next four fiscal quarter period prepared on a quarterly basis, in form and detail reasonably acceptable to the Administrative Agent and the Lenders, together with a summary of the
material assumptions made in the preparation of such annual budget or plan; </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">63 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">all such historical financial statements to be complete and correct in all material respects (subject, in
the case of interim statements, to normal recurring <FONT STYLE="white-space:nowrap">year-end</FONT> audit adjustments) and to be prepared in reasonable detail and, in the case of the annual and quarterly financial statements provided in accordance
with subsections (a)&nbsp;and (b) above, in accordance with GAAP applied consistently throughout the periods reflected therein (except as required by a change in GAAP as set forth therein) and further accompanied by a description of, and an
estimation of the effect on the financial statements on account of, a change, if any, in the application of accounting principles as provided in Section&nbsp;1.3. The financial statements provided in accordance with subsection (c)&nbsp;above shall
have been prepared in good faith based upon reasonable assumptions. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding the foregoing, financial statements and reports
required to be delivered pursuant to the foregoing provisions of this Section may be delivered electronically (including via a link to the SEC&#146;s EDGAR system) and if so, shall be deemed to have been delivered on the date on which the
Administrative Agent receives such reports from the Borrower through electronic mail. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.2</B>
<B><U>Certificates; Other Information</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Furnish to the Administrative Agent for prompt further distribution to each Lender: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Accountants&#146; Certificate</U>. Concurrently with the delivery of the financial statements referred to in
Section&nbsp;5.1(a) above, a certificate of the independent certified public accountants reporting on such financial statements stating that in making the examination necessary therefor no knowledge was obtained of any Default or Event of Default,
except as specified in such certificate. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Officer&#146;s Certificate</U>. Concurrently with the delivery of the
financial statements referred to in Sections 5.1(a) and 5.1(b) above, a certificate of a Responsible Officer substantially in the form of <U>Exhibit 5.2(b)</U> stating that (i)&nbsp;such financial statements present fairly in all material respects
the consolidated financial position of the Borrower and its Consolidated Subsidiaries for the periods indicated in conformity with GAAP applied on a consistent basis, (ii)&nbsp;each of the Credit Parties during such period observed or performed in
all material respects all of its covenants and other agreements, and satisfied every condition, contained in this Agreement to be observed, performed or satisfied by it, and (iii)&nbsp;such Responsible Officer has obtained no knowledge of any
Default or Event of Default except as specified in such certificate and such certificate shall include the calculations in reasonable detail required to indicate (A)&nbsp;compliance with Section&nbsp;5.9 as of the last day of such period,
(B)&nbsp;that each Investment made during the most recently completed fiscal quarter pursuant to clause (e)&nbsp;of the definition of Permitted Investment, together with each other then-existing Investment pursuant to clause (e)&nbsp;of the
definition of Permitted Investment, did not, when such Investment was made, exceed 15% of Consolidated total shareholders&#146; equity as determined in accordance with GAAP and as set forth on the then most recent Consolidated balance sheet of the
Borrower and its Consolidated Subsidiaries furnished to the Administrative Agent pursuant to Section&nbsp;5.1 above and (C)&nbsp;the amount of all Restricted Payments paid and all Investments (including Permitted Acquisitions) that were made during
such period. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Updated Schedules</U>. Concurrently with or prior to the delivery of the financial statements referred
to in Sections 5.1(a) and 5.1(b) above, (i)&nbsp;an updated copy of <U>Schedule 3.12</U> if the Credit Parties or any of their Subsidiaries has formed or acquired a new Subsidiary since the Closing Date or since such Schedule was last updated, as
applicable and (ii)&nbsp;an updated copy of <U>Schedule 3.21</U> if the Credit Parties or any of their Subsidiaries has materially altered or acquired any insurance policies since the Closing Date or since <U>Schedule 3.21</U> was last updated. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) <U>Reports; SEC Filings; Regulatory Reports; Press Releases; Etc.</U> Promptly upon their becoming available,
(i)&nbsp;copies of all reports (other than those provided pursuant to Section&nbsp;5.1 and those which are of a promotional nature) and other financial information which the Borrower sends to its shareholders, (ii)&nbsp;copies of all reports and all
registration statements and prospectuses (other than those on or pursuant to Form <FONT STYLE="white-space:nowrap">S-8</FONT> or any successor form), if any, which any Credit Party may make to, or file with,
</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">64 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
the SEC (or any successor or analogous Governmental Authority) that are not available on the SEC&#146;s EDGAR system (or any successor system) and (iii)&nbsp;all press releases and other
statements made available by any of the Credit Parties to the public concerning material developments in the business of any of the Credit Parties. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) [<U>Reserved]</U>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) <U>Management Letters; Etc.</U> Promptly upon receipt thereof, a copy or summary of any other report, or &#147;management
letter&#148; or similar report submitted by independent accountants to any Credit Party or any of their Subsidiaries in connection with any annual, interim or special audit of the books of such Person. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(g) <U>Debt Securities Information</U>. Promptly after the furnishing thereof, copies of any statement or report furnished to
any holder of debt securities of any Credit Party or any Subsidiary thereof pursuant to the terms of any indenture, loan or credit or similar agreement and not otherwise required to be furnished to the Lenders pursuant to Section&nbsp;5.1 or any
other clause of this Section&nbsp;5.2. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(h) <U>General Information</U>. Except as may be prohibited by a Requirement of
Law, promptly, such additional financial and other information as the Administrative Agent, on behalf of any Lender, may from time to time reasonably request. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.3</B> <B><U>Payment of Taxes and Other Obligations</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Pay, discharge or otherwise satisfy at or before maturity or before they become delinquent, as the case may be, subject, where applicable, to
specified grace periods, (a)&nbsp;all of its material Taxes (Federal, state, local and any other Taxes) and (b)&nbsp;all of its other material obligations and liabilities of whatever nature in accordance with industry practice and (c)&nbsp;any
additional material costs that are imposed as a result of any failure to so pay, discharge or otherwise satisfy such Taxes, obligations and liabilities, except when the amount or validity of any such Taxes, obligations and liabilities is currently
being contested in good faith by appropriate proceedings and reserves, if applicable, in conformity with GAAP with respect thereto have been provided on the books of the Credit Parties. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.4</B> <B><U>Conduct of Business and Maintenance of Existence</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Except as expressly permitted under Section&nbsp;6.3, continue to engage in business of the same general type as now conducted by it on the
Closing Date. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Except as permitted by Section&nbsp;6.4, preserve, renew and keep in full force and effect its corporate or other
formative existence and good standing, take all reasonable action to maintain all rights, privileges and franchises necessary or desirable in the normal conduct of its business and to maintain its goodwill and comply with all Contractual Obligations
and Requirements of Law, except to the extent where the failure to comply, individually or in the aggregate, has not had and could not reasonably be expected to have a Material Adverse Effect. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) Except as could not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect, (i)&nbsp;obtain and
maintain all certificates of need, provider numbers, permits and other licenses required to operate such Person&#146;s business and its business locations under applicable law and maintain such Person&#146;s qualification for participation in, and
payment under all applicable Government Reimbursement Programs and (ii)&nbsp;properly file all cost reports required under any applicable Government Reimbursement Program. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) (i) Provide goods or services to its customers in compliance with ethical standards, laws, rules and regulations applicable to it or any
facility or location it operates; (ii)&nbsp;assure that each of its employees and each employee of such facility or location has all required licenses, credentials, approvals and other certifications to perform his or her duties and services for
such location; and (iii)&nbsp;maintain all permits and other licenses required to operate its facilities and locations and conduct its business under applicable law; except to the extent, with respect to each of clauses&nbsp;(i), (ii), and
(iii)&nbsp;above, where the failure to comply, individually or in the aggregate, has not had and could not reasonably be expected to have a Material Adverse Effect. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">65 </P>

</DIV></Center>


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


<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">(e) (i) Implement and maintain policies that are in material compliance with HIPAA and
(ii)&nbsp;undertake to be in compliance with each of the HIPAA provisions applicable to such Credit Party that relate to or regulate billing practices, procedures and codes, standard transactions, and privacy and security of protected health
information except to the extent any failure could not reasonably be expected to have a Material Adverse Effect. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.5</B> <B><U>Maintenance of Property; Insurance</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Keep all material property useful and necessary in its business in good working order and condition (ordinary wear and tear and
obsolescence excepted). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Maintain with financially sound and reputable insurance companies liability, casualty, property and business
interruption insurance in at least such amounts and against at least such risks as are usually insured against in the same general areas by companies engaged in the same or a similar size and type of business; and furnish to the Administrative
Agent, upon the request of the Administrative Agent, full information as to the insurance carried. The Administrative Agent shall be named as additional insured, as its interest may appear, with respect to any such general liability insurance, and
use commercially reasonable efforts to cause each provider of any such insurance to agree, on a blanket basis or by endorsement upon the policy or policies issued by it or by independent instruments to be furnished to the Administrative Agent, that
it will give the Administrative Agent thirty (30)&nbsp;days prior written notice before any such policy or policies shall be materially altered or canceled, and such policies shall provide that no act or default of the Credit Parties or any of their
Subsidiaries or any other Person shall affect the rights of the Administrative Agent or the Lenders under such policy or policies; <U>provided</U>, <U>however</U>, that the Credit Parties may effect workers&#146; compensation insurance or similar
coverage with respect to operations in any particular state or other jurisdiction through an insurance fund operated by such state or jurisdiction or by meeting the self-insurance requirements of such state or jurisdiction. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) Except as could not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect, preserve or renew all of
its Intellectual Property. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.6</B> <B><U>Books and Records</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Keep proper books, records and accounts in which full, true and correct entries in conformity in all material respects with GAAP and all
Requirements of Law shall be made of all dealings and transactions in relation to its businesses and activities. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.7</B> <B><U>Notices</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Give notice in writing to the Administrative Agent (which shall promptly transmit such notice to each Lender) of: </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) promptly, but in any event within two (2)&nbsp;Business Days after any Credit Party knows thereof, the occurrence of any
Default or Event of Default; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) promptly, any default or event of default under any Contractual Obligation of any Credit
Party or any of its Subsidiaries which, individually or in the aggregate, could reasonably be expected to have a Material Adverse Effect or involve a monetary claim in excess of $10,000,000; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) promptly, any litigation, or any investigation or proceeding known or threatened in writing to any Credit Party
(i)&nbsp;affecting any Credit Party or any of its Subsidiaries which, individually or in the aggregate, could reasonably be expected to have a Material Adverse Effect or involve a monetary claim in excess of $50,000,000 or involving injunctions or
requesting injunctive relief by or against any Credit Party or any Subsidiary of any Credit Party, (ii)&nbsp;affecting or with respect to this Agreement, any other Credit Document or any security interest created thereunder, (iii)&nbsp;involving an
environmental claim or potential liability under Environmental Laws which could reasonably be expected to have, individually or in the aggregate, a Material Adverse Effect, or (iv)&nbsp;by any Governmental Authority relating to any Credit Party or
any Subsidiary thereof and alleging fraud, deception or willful misconduct by such Person which could reasonably be expected to have, individually or in the aggregate, a Material Adverse Effect; </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">66 </P>

</DIV></Center>


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


<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">(d) of any labor controversy that has resulted in, or threatens to result
in, a strike or other work action against any Credit Party which could, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) of any attachment, judgment, lien, levy or order exceeding $22,500,000 that could reasonably be expected to be assessed
against or which has been threatened in writing against any Credit Party other than Permitted Liens; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) as soon as
possible and in any event within thirty (30)&nbsp;days after any Credit Party knows or has reason to know thereof: (i)&nbsp;the occurrence or expected occurrence of any Reportable Event with respect to any Plan, a failure to make any required
contribution to a Plan, the creation of any Lien in favor of the PBGC (other than a Permitted Lien) or a Plan or any withdrawal from, or the termination, Reorganization or Insolvency of, any Multiemployer Plan or (ii)&nbsp;the institution of
proceedings or the taking of any other action by the PBGC with respect to the withdrawal from, or the terminating, Reorganization or Insolvency of, any Multiemployer Plan; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(g) promptly, any notice of any violation received by any Credit Party from any Governmental Authority including, without
limitation, any notice of violation of Environmental Laws which could reasonably be expected to cause a Material Adverse Effect; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(h) as soon as possible and in any event within two (2)&nbsp;Business Days following the occurrence of any of the following
events: (i)&nbsp;any notice is received, through letter or otherwise, of a potential investigation relating to any Credit Party&#146;s submission of claims to Government Reimbursement Programs; (ii)&nbsp;the voluntary disclosure by any Credit Party
to the Office of the Inspector General of the United States Department of Health and Human Services, a Medicare fiscal intermediary or any state&#146;s Medicaid program of a potential overpayment matter involving the submission of claims to such
payor other than refund payments made in the ordinary course of business and which are immaterial in amount or (iii)&nbsp;any notice is received from a Governmental Authority initiating any action that could result in the loss or cancellation of any
license, permit, authorization or other right related to any Healthcare Law; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) any notice is received from any
Governmental Authority of the imposition of any forfeiture or the designation of a hearing that could result in the expiration, termination, revocation, impairment or suspension of any license, permit, authorization or other right related to any
Healthcare Law which could reasonably be expected to cause a Material Adverse Effect; and </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(j) promptly, any other
development or event which could reasonably be expected to have a Material Adverse Effect. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Each notice pursuant to this Section shall be accompanied by a
statement of a Responsible Officer setting forth details of the occurrence referred to therein and stating what action the Credit Parties propose to take with respect thereto. In the case of any notice of a Default or Event of Default, the Borrower
shall specify that such notice is a Default or Event of Default notice on the face thereof. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.8</B>
<B><U>Environmental Laws</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Except as could not reasonably be expected, either individually or in the aggregate, to have a
Material Adverse Effect, comply with, all applicable Environmental Laws and obtain and comply with and maintain, any and all licenses, approvals, notifications, registrations or permits required by applicable Environmental Laws; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Except as could not reasonably be expected, either individually or in the aggregate, to have a Material Adverse Effect, conduct and
complete all investigations, studies, sampling and testing, and all remedial, removal and other actions required under Environmental Laws and promptly comply with all lawful orders and directives of all Governmental Authorities regarding
Environmental Laws except to the extent that the same are being contested in good faith by appropriate proceedings; and </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">67 </P>

</DIV></Center>


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


<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">(c) Defend, indemnify and hold harmless the Administrative Agent and the Lenders, and their
respective employees, agents, officers and directors and affiliates, from and against any and all claims, demands, penalties, fines, liabilities, settlements, damages, costs and expenses of whatever kind or nature, known or unknown, contingent or
otherwise, arising out of, or in any way relating to the violation of, noncompliance with or liability under, any Environmental Law applicable to the operations of the Credit Parties or any of their Subsidiaries or the Properties, or any orders,
requirements or demands of Governmental Authorities related thereto, including, without limitation, reasonable attorney&#146;s and consultant&#146;s fees, investigation and laboratory fees, response costs, court costs and litigation expenses, except
to the extent that any of the foregoing arise out of the gross negligence or willful misconduct of the party seeking indemnification therefor. The agreements in this paragraph shall survive repayment of the Credit Party Obligations and all other
amounts payable hereunder and termination of the Commitments and the Credit Documents. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.9</B>
<B><U>Financial Covenants</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Comply with the following financial covenants: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Consolidated Net Leverage Ratio</U>. The Consolidated Net Leverage Ratio, calculated as of the last day of each fiscal
quarter (beginning with the fiscal quarter ending December&nbsp;31, 2017) or as of any other date on a Pro Forma Basis, shall be less than or equal to <STRIKE>4.00</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">4.25</U> to 1.00.
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Interest Coverage Ratio</U>. The Interest Coverage Ratio, calculated as of the last day of each fiscal quarter
(beginning with the fiscal quarter ending December&nbsp;31, 2017) or as of any other date on a Pro Forma Basis, shall be greater than or equal to 3.00 to 1.00. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding the above, the parties hereto acknowledge and agree that, for purposes of all calculations made in determining compliance for
any applicable period with the financial covenants set forth in this Section, (i)&nbsp;after consummation of any Permitted Acquisition, (A)&nbsp;income statement items and other balance sheet items (whether positive or negative) attributable to the
Target acquired in such transaction shall be included in such calculations to the extent relating to such applicable period as if such Permitted Acquisition had been consummated as of the first day of such applicable period (including by adding any
reasonable cost saving synergies associated with such Permitted Acquisition in a manner reasonably satisfactory to the Required Lenders), subject to reasonable adjustments mutually acceptable to the Borrower and the Required Lenders and
(B)&nbsp;Indebtedness of a Target which is retired in connection with a Permitted Acquisition shall be excluded from such calculations and deemed to have been retired as of the first day of such applicable period and (ii)&nbsp;after any Disposition
permitted by Section&nbsp;6.4(a)(viii), (A)&nbsp;income statement items, cash flow statement items and balance sheet items (whether positive or negative) attributable to the property or assets disposed of shall be excluded from such calculations to
the extent relating to such applicable period as if such Disposition had been consummated as of the first day of such applicable period, subject to adjustments mutually acceptable to the Borrower and the Required Lenders and (B)&nbsp;Indebtedness
that is repaid with the proceeds of such Disposition shall be excluded from such calculations and deemed to have been repaid as of the first day of such applicable period. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">For purposes of this Section&nbsp;5.9, cost saving synergies and adjustments to income statement items, cash flow statement items and balance
sheet items reflected in financial statements provided by the Credit Parties pursuant to this Credit Agreement shall be deemed accepted by the Required Lenders, unless the Required Lenders object to such items in writing within thirty (30)&nbsp;days
of the submission of such financial statements; <U>provided</U>, that to the extent the Credit Parties revise any financial statements as a result of such objection by the Required Lenders, such financial statements shall be deemed delivered as of
the date originally submitted for all purposes of this Credit Agreement (other than the thirty (30)&nbsp;day period set forth in this paragraph, which shall begin to run with respect to such revised financial statements when such revisions are
submitted). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding the foregoing, with respect to any Target acquired pursuant to a Permitted Acquisition, beginning with the
third full fiscal quarter end to occur after such Permitted Acquisition, income statement items and other balance sheet items (whether positive or negative) attributable to such Target and included in the
</P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">68 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
Section 5.10Additional Guarantors calculations required by this Section&nbsp;5.9 shall not exceed the actual results generated by such Target (except to the extent that income statement items and
other balance sheet items that vary from actual items are approved (such approval not to be unreasonably withheld, delayed or conditioned) in writing by the Required Lenders) for the period beginning with the first day of the first full fiscal
quarter that the Target&#146;s results are included in the Borrower&#146;s consolidated financial statements and ending as of the applicable date of calculation, annualized for the full period applicable to such calculation. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.10 </B><B><U>Additional Guarantors</U>.</B> </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) The Credit Parties will cause each of their Material Domestic Subsidiaries (and any other Domestic Subsidiary that is required to become a
Guarantor pursuant to the definition of Material Domestic Subsidiary), whether newly formed, after acquired or otherwise existing <U STYLE="border-bottom:1pt double; padding-bottom:1pt">(including upon the formation of any Material Domestic
Subsidiary that is a Division Successor)</U> to promptly (and in any event within 45 days after (as applicable)&nbsp;(i) such Material Domestic Subsidiary is formed or acquired or (ii)&nbsp;financial statements are delivered pursuant to
Section&nbsp;5.1 which demonstrate that a Domestic Subsidiary has become a Material Domestic Subsidiary (or, in the case of (i)&nbsp;or (ii), such longer period of time as agreed to by the Administrative Agent in its reasonable discretion)) become a
Guarantor hereunder by way of execution of a Joinder Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) The Credit Parties will cause each of their Domestic Subsidiaries
(<U STYLE="border-bottom:1pt double; padding-bottom:1pt">including upon the formation of any Domestic Subsidiary that is a Division Successor)</U> (other than PMG), to the extent not already a Guarantor hereunder as of the end of any fiscal year
(beginning with the fiscal year ending December&nbsp;31, 2018), to become a Guarantor hereunder by way of execution of a Joinder Agreement within ninety&nbsp;(90) days after the end of such fiscal year (or such longer period of time as agreed to by
the Administrative Agent in its reasonable discretion); <U>provided</U>, <U>however</U>, that no Domestic Subsidiary shall be required to become a Guarantor pursuant to this Section&nbsp;5.10(b) if such Domestic Subsidiary (i)&nbsp;would be required
to obtain a third-party consent in connection with the execution and delivery of a Joinder Agreement, (ii)&nbsp;the execution and delivery of a Joinder Agreement would be prohibited by a provision of such Domestic Subsidiary&#146;s articles of
incorporation, bylaws, operating agreement or other comparable charter documents or (iii)&nbsp;is a shell company with nominal assets and no or nominal business operations as of the end of such fiscal year. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) In connection with the foregoing Sections 5.10(a) and (b), the Credit Parties shall deliver to the Administrative Agent, with respect to
each new Guarantor to the extent applicable, substantially the same documentation required pursuant to Sections 4.1(b) &#150; (d) and such other documents or agreements as the Administrative Agent may reasonably request. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.11 </B><B><U>Compliance with Law</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Comply with all Requirements of Law, the articles of incorporation, bylaws, articles of organization, operating agreement or other organization
documents, and orders (including Environmental Laws), and all applicable restrictions imposed by all Governmental Authorities applicable to it except (a)&nbsp;to the extent such Requirement of Law, articles of incorporation, bylaws, articles of
organization, operating agreement or other organization documents, order or restriction is being contested in good faith by appropriate proceedings diligently conducted or (b)&nbsp;to the extent noncompliance with any such Requirements of Law,
articles of incorporation, bylaws, articles of organization, operating agreement or other organization documents, order or restriction could not reasonably be expected to have, individually or in the aggregate, a Material Adverse Effect. The
Borrower will maintain in effect and enforce policies and procedures designed to ensure compliance by the Borrower, its Subsidiaries and their respective directors, officers, employees and agents with Anti-Corruption Laws and applicable Sanctions.
</P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.12 </B><B><U>Further Assurances</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a)<U> Public/Private Designation</U>. The Credit Parties will cooperate with the Administrative Agent in connection with the publication of
certain materials and/or information provided by or on behalf of the Credit Parties to the Administrative Agent and Lenders (collectively, &#147;<U>Information Materials</U>&#148;) and will designate Information Materials (i)&nbsp;that are either
available to the public or not material with respect to the Credit Parties and their<B> </B>Subsidiaries or any of their respective securities for purposes of United States federal and state securities laws, as &#147;<U>Public
</U><U>Information</U>&#148; and (ii)&nbsp;that are not Public Information as &#147;<U>Private Information</U>,&#148; which Private Information the Administrative Agent and Lenders shall keep confidential, including from any securities trading,
brokerage or securities analyst operations through appropriate &#147;Chinese Wall&#148; methods. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">69 </P>

</DIV></Center>


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


<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">(b) <U>Additional Information</U>. The Credit Parties shall provide such information
regarding the operations, business affairs and financial condition of the Credit Parties and their Subsidiaries as the Administrative Agent or any Lender may reasonably request. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Visits and Inspections</U>. Each of the Credit Parties shall permit representatives and independent contractors of the Administrative
Agent and each Lender up to two times (in the aggregate for the Administrative Agent and all Lenders) during any twelve month period to visit and inspect any of its properties, to examine its corporate, financial and operating records, and make
copies thereof or abstracts therefrom, and to discuss its affairs, finances and accounts with its directors, officers, and independent public accountants, all at the expense of the Borrower and at such reasonable times during normal business hours,
upon reasonable advance notice to the Borrower; <U>provided</U>, <U>however</U>, that when an Event of Default under Section&nbsp;7.1(a) or (f)&nbsp;exists, the Administrative Agent or any Lender (or any of their respective representatives or
independent contractors) may do any of the foregoing at the expense of the Borrower at any time during normal business hours and without advance notice and without limit to the number of visits. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) <U>Material Contracts</U>. Upon the occurrence and during the continuance of a Default or an Event of Default, upon the request of the
Administrative Agent, the Credit Parties shall provide a list of all Material Contracts, together with a copy of any Material Contract requested by the Administrative Agent (subject to any confidentiality restrictions therein). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) <U>Post Closing Deliveries</U>. Notwithstanding any provision herein or in any other Credit Document to the contrary, to the extent not
actually delivered on or prior to the Closing Date, the Borrower shall, and shall cause each Credit Party, to take the actions set forth on <U>Schedule 5.12(e)</U> within the period set forth on <U>Schedule 5.12(e)</U>. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;5.13</B><B> <U>Collateral Matters</U>.</B> At all times following the occurrence of the Collateral Event: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Execute any and all further documents, financing statements, agreements and instruments, and take all such further customary actions
(including the filing and recording of financing statements, fixture filings and other documents and recordings of Liens in stock registries), that may be required under any applicable law, or that the Administrative Agent may reasonably request, to
cause the requirements of the occurrence of the Collateral Event to remain satisfied. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) If any additional Guarantor or Foreign
Subsidiary or FSHCO is formed or acquired (<U STYLE="border-bottom:1pt double; padding-bottom:1pt">including any Guarantor that is a Division Successor)</U> after such Collateral Event, or if any additional Equity Interests of any Guarantor or
Foreign Subsidiary or FSHCO are issued after such Collateral Event, (i)&nbsp;notify the Administrative Agent thereof, and (ii)&nbsp;within 30 Business Days after such date or such longer period as the Administrative Agent shall agree,
(A)&nbsp;pledge all outstanding Equity Interests of such new Guarantor issued after such Collateral Event, pledge Equity Interests in such new Foreign Subsidiary or FSHCO issued after such Collateral Event up to an amount thereof that would qualify
as &#147;Collateral&#148;, pledge all new Equity Interests of the Guarantor issued after such Collateral Event, pledge Equity Interests of the Foreign Subsidiary or FSHCO issued after such Collateral Event up to an amount thereof that, together with
other Equity Interests in such Foreign Subsidiary or FSHCO that have previously been pledged, would qualify as &#147;Collateral&#148;, in each case to the Administrative Agent under the Collateral Agreement, except to the extent such Equity
Interests constitute Excluded Assets, and (B)&nbsp;deliver to the Administrative Agent for the benefit of the Lenders and the Bank Product Providers all certificates or other instruments (if any) representing such Equity Interests, together with
stock powers or other instruments of transfer with respect thereto endorsed in blank. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) If any additional Guarantor or Foreign
Subsidiary or FSHCO is formed or acquired (<U STYLE="border-bottom:1pt double; padding-bottom:1pt">including any Guarantor that is a Division Successor)</U> after the Collateral Event, deliver to the Administrative Agent within 30 Business Days
after such date or such longer period as the Administrative Agent shall agree, (i)&nbsp;a supplement to the Collateral Agreement, in the form specified therein, duly executed and delivered on behalf of such Credit Party and (ii) supplements to the
other Security Documents, if applicable, to cause the requirements of the occurrence of the Collateral Event to become satisfied with respect to such new Credit Party. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">70 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
(d) Furnish to the Administrative Agent prompt written notice (and in any event within 30 days) of any change in (i)&nbsp;any Credit Party&#146;s corporate or organizational name, (ii)&nbsp;any
Credit Party&#146;s organizational form or jurisdiction of organization , (iii) the location of any Credit Party&#146;s chief executive office or (iv)&nbsp;any Credit Party&#146;s organizational identification number. </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE VI </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>NEGATIVE
COVENANTS </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of the Credit Parties hereby covenants and agrees that on the Closing Date, and thereafter (a)&nbsp;for so long as
this Agreement is in effect, (b)&nbsp;until the Commitments have terminated, (c)&nbsp;until no Note remains outstanding and unpaid and the Credit Party Obligations and all other amounts owing to the Administrative Agent or any Lender hereunder are
paid in full, that: </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.1</B> <B><U>Indebtedness</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">No Credit Party will, nor will it permit any Subsidiary to, contract, create, incur, assume or permit to exist any Indebtedness, except: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Indebtedness arising or existing under this Agreement and the other Credit Documents; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Indebtedness of the Credit Parties and their Subsidiaries existing as of the Closing Date as referred to in the financial
statements referenced in Section&nbsp;3.1 (and set out more specifically in <U>Schedule 6.1(b)</U> hereto) and any renewals, refinancings or extensions thereof in a principal amount not in excess of that outstanding as of the date of such renewal,
refinancing or extension; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) Indebtedness of the Credit Parties and their Subsidiaries incurred after the Closing Date
consisting of Capital Leases or Indebtedness incurred to provide all or a portion of the purchase price or cost of construction of an asset; <U>provided</U> that (i)&nbsp;such Indebtedness when incurred shall not exceed the purchase price or cost of
construction of such asset; (ii)&nbsp;no such Indebtedness shall be renewed, refinanced or extended for a principal amount in excess of the principal balance outstanding thereon at the time of such renewal, refinancing or extension; and
(iii)&nbsp;the total amount of all such Indebtedness at any time outstanding shall not exceed the greater of (i) $125,000,000 and (ii) 2.5% of Consolidated Total Assets at such time; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) Unsecured intercompany Indebtedness among the Credit Parties or Subsidiaries of the Credit Parties that become Credit
Parties within the time required by Section&nbsp;5.10; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) Indebtedness and obligations owing under Hedging Agreements
entered into in order to manage existing or anticipated interest rate, exchange rate or commodity price risks and not for speculative purposes; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) Guaranty Obligations in respect of Indebtedness of a Credit Party to the extent such Indebtedness is permitted to exist or
be incurred pursuant to this Section; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(g) earnout obligations incurred, issued or assumed by any Credit Party as the
deferred purchase price of property or services purchased by such Credit Party which appear as liabilities on a balance sheet of such Credit Party; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(h) other unsecured Indebtedness of Credit Parties; provided, that (i)&nbsp;the Credit Parties have delivered a certificate
(including reasonably detailed supporting calculations related to the matters set forth in such certificate) of a Responsible Officer to the Administrative Agent to the effect that, after giving </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">71 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
effect to such Indebtedness on a Pro Forma Basis, no Default or Event of Default exists and the Credit Parties are in compliance with each of the financial covenants set forth in
Section&nbsp;5.9, (ii) the representations and warranties, affirmative covenants, negative covenants, financial covenants, defaults and events of default in the definitive documentation for such Indebtedness are no more restrictive than the terms
and conditions set forth in the Credit Documents and (iii)&nbsp;the terms of any such Indebtedness shall not restrict payments by the Credit Parties of the Credit Party Obligations in any way; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) Indebtedness of a Permitted JV to the extent the financial results of such Permitted JV are not Consolidated with the
financial results of the Borrower and its Subsidiaries. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.2</B> <B><U>Liens</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Parties will not, nor will they permit any Subsidiary (other than a Subsidiary that is a Permitted JV) to, contract, create, incur,
assume or permit to exist any Lien with respect to any of their respective property or assets of any kind (whether real or personal, tangible or intangible), whether now owned or hereafter acquired, except for Permitted Liens. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.3</B> <B><U>Nature of Business</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Engage in any material line of business substantially different from those lines of business conducted by the Borrower and its Subsidiaries as
of the Closing Date or any business substantially related or incidental thereto, except as approved by the Required Lenders (such approval not to be unreasonably withheld, conditioned or delayed). </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section&nbsp;6.4 <U>Consolidation, Merger, Sale or Purchase of Assets, etc</U>.</B> </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Parties will not, nor will they permit any Subsidiary to, </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) dissolve, liquidate or wind up its affairs, or sell, transfer, lease,
<U STYLE="border-bottom:1pt double; padding-bottom:1pt">consummate a Division as the Dividing Person</U> or otherwise dispose of its property or assets (each a &#147;<U>Disposition</U>&#148;) or agree to do so at a future time, except the following,
without duplication, shall be expressly permitted: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) (A)&nbsp;the sale, transfer, lease or other disposition of
inventory and materials in the ordinary course of business and (B)&nbsp;the conversion of cash into Cash Equivalents and Cash Equivalents into cash; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) the sale, transfer or other disposition of property or assets to an unrelated party not in the ordinary course of business
where and to the extent that they are the result of a Recovery Event; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) the sale, lease, transfer or other disposition
of (A)&nbsp;machinery, parts and equipment no longer used or useful in the conduct of the business of the Credit Parties or any of their Subsidiaries and (B)&nbsp;obsolete or worn out property, whether now owned or hereafter acquired, in the
ordinary course of business; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iv) the sale, lease or transfer of property or assets from one Credit Party to another
Credit Party or dissolution of any Credit Party to the extent any and all assets are distributed to another Credit Party; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(v) the termination of any Hedging Agreement; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(vi) Dispositions of equipment or real property to the extent that (A)&nbsp;such property is exchanged for credit against the
purchase price of similar replacement property within twelve (12)&nbsp;months of such Disposition or (B)&nbsp;the proceeds of such Disposition are reasonably promptly applied to the purchase price of such replacement property within 12 months of
such Disposition; </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">72 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(vii) the licensing of Intellectual Property in the ordinary course of
business consistent with past practice; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(viii) Dispositions by the Borrower or any Subsidiary; <U>provided</U> that at any
time after the Collateral Event, (i)&nbsp;with respect to asset sales for more than $300,000,000 per disposition or series of related dispositions, at least 75% of the consideration for any such asset sale shall consist of cash or cash equivalents
(provided that for purposes of the 75% cash consideration requirement (x)&nbsp;the amount of any Indebtedness or other liabilities of the Borrower or any Subsidiary (as shown on such person&#146;s most recent balance sheet or in the notes thereto)
that are assumed by the transferee of any such assets, (y)&nbsp;the amount of any <FONT STYLE="white-space:nowrap">trade-in</FONT> value applied to the purchase price of any replacement assets acquired in connection with such asset sale, and
(z)&nbsp;any securities received by the Borrower or such Subsidiary from such transferee that are converted by the Borrower or such Subsidiary into cash or cash equivalents (to the extent of the cash or cash equivalents received) within 270 days
following the closing of the applicable asset sale, shall each be deemed to be cash or cash equivalents) and (ii)&nbsp;immediately prior to the consummation of such asset sale, no Event of Default shall have occurred and be continuing and no Event
of Default shall result therefrom; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ix) the sale, lease or transfer of property or assets as part of a Sale and Leaseback
Transaction; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(x) the merger of a Credit Party or a Subsidiary thereof with another Credit Party or a Subsidiary thereof to
the extent permitted by Section&nbsp;6.4(b)(ii) below; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(xi) Dispositions of Equity Interests in Permitted JVs pursuant to
the terms of the joint venture or equivalent agreements governing such Permitted JVs so long as such joint venture or equivalent agreements are not solely between Persons that are Credit Parties, Subsidiaries or Affiliates of Credit Parties; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(xii) terminations of leases by a Credit Party or a Subsidiary in the ordinary course of business that do not interfere in any
material respect with the business of the Credit Parties or their Subsidiaries; <STRIKE>and</STRIKE> </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><U STYLE="border-bottom:1pt double; padding-bottom:1pt">(xiii)</U> <U STYLE="border-bottom:1pt double; padding-bottom:1pt">any
Subsidiary that is an LLC may consummate a Division as the Dividing Person if, immediately upon the consummation of the Division, the assets of the applicable Dividing Person are held by one or more Subsidiaries at such time, or, with respect to
assets not so held by one or more Subsidiaries, such Division, in the aggregate, would otherwise result in a Disposition permitted by Section&nbsp;6.4(a)(viii) or (x)&nbsp;above; and</U> </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(<STRIKE>xiii</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">xiv</U>) any sale, transfer, assignment,
disposition, abandonment or lapse of Intellectual Property that is no longer commercially practicable, usable or desirable in the conduct of business, in the ordinary course of business; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman"><U>provided</U> that (A)&nbsp;after giving effect to any Disposition pursuant to clauses (viii)&nbsp;and (xi) above, the Credit Parties shall
be in compliance on a Pro Forma Basis with the financial covenants set forth in Section&nbsp;5.9 hereof, recalculated for the most recently ended month for which information is available, and (B)&nbsp;with respect to clauses (v), (vi), (viii) and
(xi)&nbsp;above, no Default or Event of Default shall exist or shall result therefrom; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) (i)&nbsp;purchase, lease or
otherwise acquire (in a single transaction or a series of related transactions) the property or assets of any Person, other than (A)&nbsp;Permitted Investments and (B)&nbsp;except as otherwise limited or prohibited herein, purchases or other
acquisitions of inventory, materials, property and equipment in the ordinary course of business, or (ii)&nbsp;consummate any transaction of merger, <U STYLE="border-bottom:1pt double; padding-bottom:1pt">Division as the Dividing Person</U> or
consolidation, except for (A)&nbsp;Investments or acquisitions (<U STYLE="border-bottom:1pt double; padding-bottom:1pt">including pursuant to a Division</U>) permitted pursuant to Section&nbsp;6.5 so long as the Credit Party subject to such
merger<STRIKE> or</STRIKE>, <U STYLE="border-bottom:1pt double; padding-bottom:1pt">Division</U> </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">73 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
<U STYLE="border-bottom:1pt double; padding-bottom:1pt">or</U> consolidation is the surviving entity, (B)&nbsp;(y) the merger or consolidation of a Subsidiary that is not a Credit Party with and
into a Credit Party; <U>provided</U> that such Credit Party will be the surviving entity and (z)&nbsp;the merger or consolidation of a Credit Party with and into another Credit Party; <U>provided</U> that if the Borrower is a party thereto, the
Borrower will be the surviving corporation <STRIKE>and</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">,</U> (C)&nbsp;the merger or consolidation of a Subsidiary that is not a Credit Party with and into another Subsidiary that is not
a Credit Party<STRIKE>.</STRIKE> <U STYLE="border-bottom:1pt double; padding-bottom:1pt">and (D)&nbsp;any Credit Party or any Subsidiary may consummate a Division as the Dividing Person if, immediately upon the consummation of the Division,
(x)&nbsp;the assets of the applicable Dividing Person are held by a Credit Party or one or more Subsidiaries at such time or, (y)&nbsp;with respect to assets not held by a Credit Party or one or more Subsidiaries, such Division, in the aggregate,
would otherwise be permitted by this Section&nbsp;6.4 (without reliance on this subclause (D)) and/or Section&nbsp;6.5</U>. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.5</B> <B><U>Investments and Acquisitions</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Parties will not, nor will they permit any Subsidiary (other than a Subsidiary that is a Permitted JV) to, make any Investment or
contract to make any Investment except for Permitted Investments. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.6</B> <B><U>Transactions with
Affiliates</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Other than execution, consummation and performance of each Management Agreement and Restrictive Agreement, the Credit
Parties will not, nor will they permit any Subsidiary to, enter into any transaction or series of transactions, whether or not in the ordinary course of business, with any officer, director, shareholder or Affiliate (other than a Subsidiary) other
than on terms and conditions substantially as favorable as would be obtainable in a comparable <FONT STYLE="white-space:nowrap">arm&#146;s-length</FONT> transaction with a Person other than an officer, director, shareholder or Affiliate, it being
understood that payments of insurance premiums by any Credit Party to PMG shall not violate this Section&nbsp;6.6. Notwithstanding the foregoing, this Section&nbsp;6.6 shall not apply to (a)&nbsp;any transaction that involves an amount less than or
equal to the greater of (i) $120,000 or (ii)&nbsp;the amount set forth in Item 404(a) of Regulation <FONT STYLE="white-space:nowrap">S-K</FONT> of the SEC as in effect from time to time; provided, that such amount shall not exceed $250,000, (b) any
transaction pertaining to director or executive officer compensation, benefits and perquisites that are approved in accordance with the charter of the Compensation Committee of the Borrower&#146;s Board of Directors or by the Borrower&#146;s Board
of Directors and (c)&nbsp;any transaction between a Credit Party or a Subsidiary thereof and another Credit Party or a Subsidiary thereof. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.7</B> <B><U>Ownership of Subsidiaries; Restrictions</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Parties will not sell, transfer, pledge or otherwise dispose of any Equity Interest or other equity interests in any of their
Subsidiaries, nor will they permit any of their Subsidiaries to issue, sell, transfer, pledge or otherwise dispose of any of their Equity Interest or other equity interests, except in a transaction permitted by Section&nbsp;6.4 or pursuant to the
exercise of rights under a Restrictive Agreement. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.8</B> <B><U>Corporate Changes; Material
Contracts</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">No Credit Party will, nor will it permit any of its Subsidiaries to, (a)&nbsp;change its fiscal year, (b)&nbsp;amend,
modify or change its articles of incorporation, certificate of designation (or corporate charter or other similar organizational document) operating agreement or bylaws (or other similar document) in any respect materially adverse to the interests
of the Lenders without the prior written consent of the Required Lenders; <U>provided</U> that no Credit Party shall (i)&nbsp;except as permitted under Section&nbsp;6.4,&nbsp;alter its legal existence or, in one transaction or a series of
transactions, merge into or consolidate with any other entity <U STYLE="border-bottom:1pt double; padding-bottom:1pt">or consummate a Division as the Dividing Person</U>, (ii)&nbsp;sell all or substantially all of its assets, (iii)&nbsp;change its
state of incorporation or organization or (iv)&nbsp;change its registered legal name, without providing thirty (30)&nbsp;days prior written notice to the Administrative Agent, (c)&nbsp;have any oral operating agreement (or other similar agreement)
or enter into a written operating agreement which regulates the affairs of such Credit Party, the conduct of its business, establishes duties, and/or governs the relations among any members, managers and such Credit Party in either case that is
materially adverse to the interests of the Lenders, it being further agreed that if any such oral or written agreement is entered into, the Borrower shall provide a materially complete description of such oral agreement or a copy of such written
agreement to the Administrative Agent within five (5)&nbsp;Business Days thereafter, (d)&nbsp;amend, modify, cancel or terminate or refuse to renew or extend or permit the amendment, modification, cancellation or termination of any of its Material
Contracts to the extent </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">74 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
such amendment, modification, cancellation or termination could reasonably be expected to have a Material Adverse Effect, (e)&nbsp;have more than one state of incorporation, organization or
formation or (f)&nbsp;change its accounting method (except in accordance with GAAP or as required by a change in Tax law) in any manner adverse to the interests of the Lenders without the prior written consent of the Required Lenders. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.9</B> <B><U>Limitation on Restricted Actions</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Parties will not, nor will they permit any Subsidiary (other than a Subsidiary that is a Permitted JV) to, directly or indirectly,
create or otherwise cause or suffer to exist or become effective any encumbrance or restriction on the ability of any such Person to (a)&nbsp;pay dividends or make any other distributions to any Credit Party on its Equity Interest or with respect to
any other interest or participation in, or measured by, its profits, (b)&nbsp;pay any Indebtedness or other obligation owed to any Credit Party, (c)&nbsp;make loans or advances to any Credit Party, (d)&nbsp;sell, lease or transfer any of its
properties or assets to any Credit Party, or (e)&nbsp;act as a Guarantor pursuant to the Credit Documents or any renewals, refinancings, exchanges, refundings or extension thereof or amend or otherwise modify the Credit Documents, except (in respect
of any of the matters referred to in clauses <FONT STYLE="white-space:nowrap">(a)-(d)</FONT> above) for such encumbrances or restrictions existing under or by reason of (i)&nbsp;this Agreement and the other Credit Documents, (ii)&nbsp;applicable
law, (iii)&nbsp;any document or instrument governing Indebtedness incurred pursuant to Section&nbsp;6.1(c); <U>provided</U> that any such restriction contained therein relates only to the asset or assets constructed or acquired in connection
therewith, (iv)&nbsp;any Permitted Lien or any document or instrument governing any Permitted Lien; <U>provided</U> that any such restriction contained therein relates only to the asset or assets subject to such Permitted Lien, (v)&nbsp;customary
provisions in leases restricting the assignment thereof, or (vi)&nbsp;any Management Agreement. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.10</B>
<B><U>Restricted Payments</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Parties will not, nor will they permit any Subsidiary to, directly or indirectly, declare,
order, make or set apart any sum for or pay any Restricted Payment, except: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) to make dividends payable solely in the
same class of Equity Interest of such Person; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) to make Restricted Payments to any Credit Party; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) to purchase, redeem or otherwise acquire Equity Interests issued by it with the proceeds received from the substantially
concurrent issue of new shares of its common stock or other common Equity Interests; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) so long as after giving effect to
such payments the Credit Parties shall be in compliance with each of the financial covenants set forth in Section&nbsp;5.9 hereof, to make regularly scheduled payments of (i)&nbsp;interest to the holders of Subordinated Debt and (ii)&nbsp;principal
to the holders of Subordinated Debt incurred in connection with any Permitted Acquisition, in each case in accordance with the terms thereof; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) any payment with respect to any earnout obligation incurred as the deferred purchase price of property or services
purchased by such Person; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) to make other Restricted Payments in an aggregate amount not to exceed the greater of (x)
$100,000,000 in any fiscal year and (y)&nbsp;an unlimited amount so long as, with respect to clause (y)&nbsp;after giving effect to each such Restricted Payment on a Pro Forma Basis (i)&nbsp;no Default or Event of Default shall then exist or would
result therefrom and (ii)&nbsp;the Consolidated Net Leverage Ratio of the Credit Parties would be less than or equal to 3.75 to 1.00; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(g) any redemption, retirement, sinking fund or similar payment, purchase or other acquisition for value, direct or indirect,
of any shares (or equivalent) of any class of Equity Interest of any Permitted JV, now or hereafter outstanding; and </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">75 </P>

</DIV></Center>


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


<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">(h) any payment made to retire, or to obtain the surrender of, any
outstanding warrants, options or other rights to acquire shares of any class of Equity Interest of any Permitted JV, now or hereafter outstanding. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.11</B><B> <U>Amendment of Subordinated Debt</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Parties will not, nor will they permit any Subsidiary (other than Indebtedness incurred pursuant to Section&nbsp;6.1(i) by a
Subsidiary that is a Permitted JV) to, without the prior written consent of the Required Lenders, amend, modify, waive or extend or permit the amendment, modification, waiver or extension of any term of any document governing or relating to any
Subordinated Debt in a manner that is materially adverse to the interests of the Lenders. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.12 </B><B><U>No
Further Negative Pledges</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Parties will not, nor will they permit any Subsidiary (other than a Subsidiary that is a
Permitted JV) to, enter into, assume or become subject to any agreement prohibiting or otherwise restricting the creation or assumption of any Lien upon any of their properties or assets, whether now owned or hereafter acquired, or requiring the
grant of any security for such obligation if security is given for some other obligation, except (a)&nbsp;pursuant to this Agreement and the other Credit Documents, (b)&nbsp;pursuant to any document or instrument governing Indebtedness incurred
pursuant to Section&nbsp;6.1(c); <U>provided</U> that any such restriction contained therein relates only to the asset or assets constructed or acquired in connection therewith, (c)&nbsp;pursuant to any document or instrument governing Indebtedness
incurred pursuant to Sections 6.1(f) or 6.1(h), (d)&nbsp;in connection with any Permitted Lien or any document or instrument governing any Permitted Lien; <U>provided</U> that any such restriction contained therein relates only to the asset or
assets subject to such Permitted Lien, (e)&nbsp;customary provisions in leases restricting the assignment thereof and (f)&nbsp;pursuant to any Management Agreement to the extent that any such Management Agreement is subject to the provisions of
Section&nbsp;9.23. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.13 </B><B><U>Restrictions Regarding PMG</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) The Borrower will not, at any time, own less than 100% of the Equity Interests of PMG and (b)&nbsp;PMG shall not engage in any business, or
have any operations or liabilities, other than providing insurance services in the nature of a &#147;captive&#148; insurance company. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;6.14</B><B> Use of Proceeds and Letters of Credit</B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) The Borrower will not request any Loans or Letter of Credit, and the Borrower shall not use, and shall procure that its Subsidiaries and
its or their respective directors, officers, employees and agents shall not use, the proceeds of any Loans or Letter of Credit (A)&nbsp;in furtherance of an offer, payment, promise to pay, or authorization of the payment or giving of money, or
anything else of value, to any Person in violation of any Anti-Corruption Laws, (B)&nbsp;for the purpose of funding, financing or facilitating any activities, business or transaction of or with any Sanctioned Person, or in any Sanctioned Country, or
(C)&nbsp;in any manner that would result in the violation of any Sanctions applicable to any party hereto. </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE VII </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>EVENTS OF DEFAULT </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;7.1</B><B> <U>Events of Default</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">An Event of Default shall exist upon the occurrence of any of the following specified events (each an &#147;<U>Event of Default</U>&#148;):
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a)<U>Payment</U>. (i)&nbsp;The Borrower shall fail to pay any principal on any Loan or Note when due (whether at
maturity, by reason of acceleration or otherwise) in accordance with the terms hereof or thereof; (ii)&nbsp;the Borrower shall fail to reimburse the Issuing Lenders for any LOC Obligations when due </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">76 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
(whether at maturity, by reason of acceleration or otherwise) in accordance with the terms hereof; (iii)&nbsp;the Borrower shall fail to pay any interest on any Loan or any fee or other amount
payable hereunder when due (whether at maturity, by reason of acceleration or otherwise) in accordance with the terms hereof and such failure shall continue unremedied for three (3)&nbsp;Business Days; or (iv)&nbsp;or any Guarantor shall fail to pay
on the Guaranty in respect of any of the foregoing or in respect of any other Guaranty Obligations hereunder (after giving effect to the grace period in clause (iii)); or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Misrepresentation</U>. Any representation or warranty made or deemed made herein or in any of the other Credit Documents
or which is contained in any certificate, document or financial or other statement furnished at any time under or in connection with this Agreement shall (i)&nbsp;with respect to representations and warranties that contain a materiality
qualification, prove to have been incorrect, false or misleading and (ii)&nbsp;with respect to representations and warranties that do not contain a materiality qualification, prove to have been incorrect, false or misleading in any material respect,
in each case on or as of the date made or deemed made; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Covenant Default</U>. (i)&nbsp;Any Credit Party shall
fail to perform, comply with or observe any term, covenant or agreement applicable to it contained in Sections 5.1 (financial statements), 5.2(a) (accountants&#146; certificate), 5.2(b) (officer&#146;s certificate),<B> </B>5.7(a) (notices), 5.9
(financial covenants),<B> </B>or <U>Article VI</U> hereof; (ii)&nbsp;any Credit Party shall fail to comply with Section&nbsp;5.5(b) (insurance) and, with respect to this clause (ii)&nbsp;only, such breach or failure to comply is not cured within
thirty&nbsp;(30) days after its occurrence or (iii)&nbsp;any Credit Party shall fail to comply with any other covenant contained in this Agreement or the other Credit Documents or any other agreement, document or instrument among any Credit Party,
the Administrative Agent and the Lenders or executed by any Credit Party in favor of the Administrative Agent or the Lenders (other than as described in Sections&nbsp;7.1(a), 7.1(c)(i) or 7.1(c)(ii) above) and, with respect to this clause
(iii)&nbsp;only, such breach or failure to comply is not cured within the earlier of (A)&nbsp;thirty (30) days after the Borrower became aware of its occurrence or (B)&nbsp;forty-five (45)&nbsp;days after its occurrence; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) <U>Material Indebtedness Cross-Default</U>. (i)&nbsp;Any Credit Party or any of its Subsidiaries shall default in any
payment of principal of or interest on any Indebtedness (other than the Loans, Reimbursement Obligations, the Guaranty and any other amounts payable under the Credit Documents) in a principal amount outstanding of at least $60,000,000 for the Credit
Parties and any of their Subsidiaries in the aggregate beyond any applicable grace period, if any, provided in the instrument or agreement under which such Indebtedness was created; or (ii)&nbsp;any Credit Party or any of its Subsidiaries shall
default in the observance or performance of any other agreement or condition relating to any Indebtedness (other than the Loans, Reimbursement Obligations, the Guaranty and any other amounts payable under the Credit Documents) in a principal amount
outstanding of at least $60,000,000<B> </B>in the aggregate for the Credit Parties and their Subsidiaries or contained in any instrument or agreement evidencing, securing or relating thereto, or any other event shall occur or condition exist, the
effect of which default or other event or condition is to cause, or to permit the holder or holders of such Indebtedness or beneficiary or beneficiaries of such Indebtedness (or a trustee or agent on behalf of such holder or holders or beneficiary
or beneficiaries) to cause, with the giving of notice if required, all of such Indebtedness to become immediately due and payable prior to its stated maturity or to be repurchased, prepaid, deferred or redeemed (automatically or otherwise); or
(iii)&nbsp;there occurs under any Hedging Agreement that is a Bank Product an Early Termination Date (as defined in such Hedging Agreement) resulting from (A)&nbsp;any event of default under such Hedging Agreement as to which the Borrower or any
Subsidiary is the Defaulting Party (as defined in such Hedging Agreement) or (B)&nbsp;any Termination Event (as defined in such Hedging Agreement) under such Hedging Agreement as to which the Borrower or any Subsidiary is an Affected Party (as
defined in such Hedging Agreement) and, in either event, the Swap Termination Value owed by such Person as a result thereof is greater than $7,500,000; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) <U>Other Cross-Defaults</U>. To the extent any such default could reasonably be expected to have a Material Adverse Effect,
the Credit Parties or any of their Subsidiaries shall default in (i)&nbsp;the payment when due under any Material Contract or (ii)&nbsp;the performance or observance, of any obligation or condition of any Material Contract and, in the case of this
clause (ii)&nbsp;only, such failure to perform or observe such other obligation or condition continues unremedied for a period of thirty (30)&nbsp;days after notice of the occurrence of such default (or such longer grace or cure period as provided
in the Material Contract) unless, but only as long as, the existence of any such default is being contested by the Credit Parties in good faith by appropriate proceedings and adequate reserves in respect thereof have been established on the books of
the Credit Parties to the extent required by GAAP; or </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">77 </P>

</DIV></Center>


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


<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">(f) <U>Bankruptcy Default</U>. (i)&nbsp;A Credit Party or any of its
Subsidiaries shall commence any case, proceeding or other action (A)&nbsp;under any existing or future law of any jurisdiction, domestic or foreign, relating to bankruptcy, insolvency, reorganization or relief of debtors, seeking to have an order
for relief entered with respect to it, or seeking to adjudicate it a bankrupt or insolvent, or seeking reorganization, arrangement, adjustment, <FONT STYLE="white-space:nowrap">winding-up,</FONT> liquidation, dissolution, composition or other relief
with respect to it or its debts, or (B)&nbsp;seeking appointment of a receiver, trustee, custodian, conservator or other similar official for it or for all or any substantial part of its assets, or a Credit Party or any of its Subsidiaries shall
make a general assignment for the benefit of its creditors; or (ii)&nbsp;there shall be commenced against a Credit Party or any of its Subsidiaries any case, proceeding or other action of a nature referred to in clause&nbsp;(i) above which
(A)&nbsp;results in the entry of an order for relief or any such adjudication or appointment or (B)&nbsp;remains undismissed, undischarged or unbonded for a period of sixty&nbsp;(60) days; or (iii)&nbsp;there shall be commenced against a Credit
Party or any of its Subsidiaries any case, proceeding or other action seeking issuance of a warrant of attachment, execution, distraint or similar process against all or any substantial part of their assets which results in the entry of an order for
any such relief which shall not have been vacated, discharged, or stayed or bonded pending appeal within sixty (60)&nbsp;days from the entry thereof; or (iv)&nbsp;a Credit Party or any of its Subsidiaries shall take any action in furtherance of, or
indicating its consent to, approval of, or acquiescence in, any of the acts set forth in clause (i), (ii), or (iii)&nbsp;above; or (v)&nbsp;a Credit Party or any of its Subsidiaries shall generally not, or shall be unable to, or shall admit in
writing their inability to, pay its debts as they become due; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(g) <U>Judgment Default</U>. One or more judgments or
decrees shall be entered against a Credit Party or any of its Subsidiaries involving in the aggregate a liability (to the extent not covered by insurance) of $75,000,000<B> </B>or more and all such judgments or decrees shall not have been paid and
satisfied, vacated, discharged, stayed or bonded pending appeal within twenty (20)&nbsp;Business Days from the entry thereof or any injunction, temporary restraining order or similar decree shall be issued against a Credit Party or any of its
Subsidiaries that, individually or in the aggregate, could result in a Material Adverse Effect; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(h) <U>ERISA
Default</U>. The occurrence of any of the following: (i)&nbsp;Any Person shall engage in any &#147;prohibited transaction&#148; (as defined in Section&nbsp;406 of ERISA or Section&nbsp;4975 of the Code) involving any Plan, (ii)&nbsp;any
&#147;accumulated funding deficiency&#148; (as defined in Section&nbsp;302 of ERISA), whether or not waived, shall exist with respect to any Plan or any Lien in favor of the PBGC or a Plan (other than a Permitted Lien) shall arise on the assets of
the Credit Parties or any Commonly Controlled Entity, (iii)&nbsp;a Reportable Event shall occur with respect to, or proceedings shall commence to have a trustee appointed, or a trustee shall be appointed, to administer or to terminate, any Single
Employer Plan, which Reportable Event or commencement of proceedings or appointment of a trustee is, in the reasonable opinion of the Required Lenders, likely to result in the termination of such Plan for purposes of Title IV of ERISA, (iv)&nbsp;any
Single Employer Plan shall terminate for purposes of Title IV of ERISA, (v)&nbsp;a Credit Party, any of its Subsidiaries or any Commonly Controlled Entity shall, or in the reasonable opinion of the Required Lenders is likely to, incur any liability
in connection with a withdrawal from, or the Insolvency or Reorganization of, any Multiemployer Plan or (vi)&nbsp;any other similar event or condition shall occur or exist with respect to a Plan, which in any of the foregoing cases in clauses
(i)&nbsp;through (vi), results in a liability to any Credit Party in excess of $30,000,000; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) <U>Change of
Control</U>. There shall occur a Change of Control; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(j) <U>Invalidity of Guaranty</U>. At any time after the execution
and delivery thereof, the Guaranty, for any reason other than the satisfaction in full of all Credit Party Obligations, shall cease to be in full force and effect (other than in accordance with its terms) or shall be declared to be null and void, or
any Credit Party shall contest the validity, enforceability, perfection or priority of the Guaranty, any Credit Document, or any Lien granted thereunder in writing or deny in writing that it has any further liability, including with respect to
future advances by the Lenders, under any Credit Document to which it is a party; or </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">78 </P>

</DIV></Center>


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


<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">(k) <U>Invalidity of Credit Documents</U>. Any Credit Document shall fail to
be in full force and effect or to give the Administrative Agent and/or the Lenders the security interests, liens, rights, powers, priority and privileges purported to be created thereby (except as such documents may be terminated or no longer in
force and effect in accordance with the terms thereof, other than those indemnities and provisions which by their terms shall survive); or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(l) <U>Licenses/Permits/Certifications/Qualifications</U>. (i)&nbsp;A state or federal regulatory agency or other Governmental
Authority shall have revoked, cancelled, failed to renew or adversely modified any license, permit, certificate, authorization or Government Reimbursement Program qualification pertaining to the business of any Credit Party, regardless of whether
such license, permit, certificate, authorization or qualification was held by or originally issued for the benefit of such Credit Party, a tenant or any other Person except where such revocation could not, individually or in the aggregate,
reasonably be expected to have a Material Adverse Effect or (ii)&nbsp;any of the Credit Parties or their Subsidiaries or their officers, employees or agents engage in activities which are prohibited by any of the federal Medicare and Medicaid
Anti-Kickback States, 42 U.S.C. <FONT STYLE="white-space:nowrap">&#167;&#167;1320a-7b,</FONT> the Ethics In Patient Referrals Act (the &#147;<U>Stark Law</U>&#148;), 42 U.S.C. &#167;&#167;1395nn, as amended, the regulations promulgated thereunder,
or related state or local statutes or regulations or which are prohibited by rules of professional conduct, except where failure to do so could not reasonably be expected, individually or in the aggregate, to have a Material Adverse Effect; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(m) <U>Subordinated Debt</U>. The subordination provisions contained in any Subordinated Debt shall cease to be in full force
and effect or shall cease to give the Lenders the rights, powers and privileges purported to be created thereby; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(n)
<U>Classification as Senior Debt</U>. The Credit Party Obligations shall cease to be classified as &#147;Senior Indebtedness,&#148; &#147;Designated Senior Indebtedness&#148; or any similar designation under any Subordinated Debt instrument; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(o) <U>Liens</U>. At any time following the Collateral Event, (i)&nbsp;any Lien on any material portion of the Collateral
granted in connection therewith or required to be granted pursuant to Section&nbsp;5.13 to the Administrative Agent ceases to be a valid and perfected Lien (or the priority of such Lien ceases to be in full force and effect), except to the extent
that any such loss of validity, perfection or priority results from the failure of the Agent to maintain possession of Collateral requiring perfection through control or to file or record any document, or (ii)&nbsp;any material provision of any
Security Document ceases to be in full force and effect or any Credit Party denies in writing the enforceability thereof. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Once a Default
occurs under the Credit Documents, then such Default will continue to exist until it either is cured (to the extent specifically permitted) in accordance with the Credit Documents or is otherwise expressly waived by Administrative Agent (with the
approval of requisite Lenders (in their sole and absolute discretion) as determined in accordance with Section&nbsp;9.1); and once an Event of Default occurs under the Credit Documents, then such Event of Default will continue to exist until it is
cured to the satisfaction of, or expressly waived by, Administrative Agent with the approval of the requisite Lenders, as required hereunder (in their sole and absolute discretion) in Section&nbsp;9.1. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;7.2</B> <B><U>Acceleration; Remedies</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Upon the occurrence and during the continuance of an Event of Default, then, and in any such event, (a)&nbsp;if such event is a Bankruptcy
Event, automatically the Commitments shall immediately terminate and the Loans (with accrued interest thereon), and all other amounts under the Credit Documents (including, without limitation, the maximum amount of all contingent liabilities under
Letters of Credit) shall immediately become due and payable, and (b)&nbsp;if such event is any other Event of Default, any or all of the following actions may be taken: (i)&nbsp;with the written consent of the Required Lenders, the Administrative
Agent may, or upon the written request of the Required Lenders, the Administrative Agent shall, declare the Commitments to be terminated forthwith, whereupon the Commitments shall immediately terminate; (ii)&nbsp;the Administrative Agent may, or
upon the written request of the </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">79 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
Required Lenders, the Administrative Agent shall, declare the Loans (with accrued interest thereon) and all other amounts owing under this Agreement and the Notes to be due and payable forthwith
and direct the Borrower to pay to the Administrative Agent Cash Collateral as security for the LOC Obligations for subsequent drawings under then outstanding Letters of Credit an amount equal to the maximum amount of which may be drawn under Letters
of Credit then outstanding, whereupon the same shall immediately become due and payable; and/or (iii)&nbsp;with the written consent of the Required Lenders, the Administrative Agent may, or upon the written request of the Required Lenders, the
Administrative Agent shall, exercise such other rights and remedies as provided under the Credit Documents and under applicable law. </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE VIII </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>THE
ADMINISTRATIVE AGENT </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;8.1</B> <B><U>Appointment and Authority</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of the Lenders and each of the Issuing Lenders hereby irrevocably appoints JPMCB to act on its behalf as the Administrative Agent
hereunder and under the other Credit Documents and authorizes the Administrative Agent to take such actions on its behalf and to exercise such powers as are delegated to the Administrative Agent by the terms hereof or thereof, together with such
actions and powers as are reasonably incidental thereto. The provisions of this Article are solely for the benefit of the Administrative Agent, the Lenders and the Issuing Lenders, and neither the Borrower nor any other Credit Party shall have
rights as a third party beneficiary of any of such provisions. It is understood and agreed that the use of the term &#147;agent&#148; herein or in any other Credit Documents (or any other similar term) with reference to the Administrative Agent is
not intended to connote any fiduciary or other implied (or express) obligations arising under agency doctrine of any applicable law. Instead such term is used as a matter of market custom, and is intended to create or reflect only an administrative
relationship between contracting parties. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;8.2</B> <B><U>Nature of Duties</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Anything herein to the contrary notwithstanding, none of the bookrunners, arrangers, syndication agent or other agents listed on the cover page
hereof shall have any powers, duties or responsibilities under this Agreement or any of the other Credit Documents, except in its capacity, as applicable, as the Administrative Agent, a Lender or an Issuing Lender hereunder. Without limiting the
foregoing, none of the Lenders or other Persons so identified shall have or be deemed to have any fiduciary relationship with any Lender. Each Lender acknowledges that it has not relied, and will not rely, on any of the Lenders or other Persons so
identified in deciding to enter into this Agreement or in taking or not taking action hereunder. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Administrative Agent may perform any
and all of its duties and exercise its rights and powers hereunder or under any other Credit Document by or through any one or more <FONT STYLE="white-space:nowrap">sub-agents</FONT> appointed by the Administrative Agent. The Administrative Agent
and any such <FONT STYLE="white-space:nowrap">sub-agent</FONT> may perform any and all of its duties and exercise its rights and powers by or through their respective Related Parties. The exculpatory provisions of this Article shall apply to any
such <FONT STYLE="white-space:nowrap">sub-agent</FONT> and to the Related Parties of the Administrative Agent and any such <FONT STYLE="white-space:nowrap">sub-agent,</FONT> and shall apply to their respective activities in connection with the
syndication of the credit facilities provided for herein as well as activities as Administrative Agent. The Administrative Agent shall not be responsible for the negligence or misconduct of any subagents except to the extent that a court of
competent jurisdiction determines in a final and nonappealable judgment that the Administrative Agent acted with gross negligence or willful misconduct in the selection of such <FONT STYLE="white-space:nowrap">sub-agents.</FONT> </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;8.3</B> <B><U>Exculpatory Provisions</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Administrative Agent shall not have any duties or obligations except those expressly set forth herein and in the other Credit Documents,
and its obligations hereunder shall be administrative in nature. Without limiting the generality of the foregoing, the Administrative Agent: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) shall not be subject to any fiduciary or other implied duties, regardless of whether a Default has occurred and is
continuing; </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">80 </P>

</DIV></Center>


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


<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">(b) shall not have any duty to take any discretionary action or exercise any
discretionary powers, except discretionary rights and powers expressly contemplated hereby or by the other Credit Documents that the Administrative Agent is required to exercise as directed in writing by the Required Lenders (or such other number or
percentage of the Lenders as shall be expressly provided for herein or in the other Credit Documents), <U>provided</U> that the Administrative Agent shall not be required to take any action that, in its opinion or the opinion of its counsel, may
expose the Administrative Agent to liability or that is contrary to any Credit Document or applicable law, including for the avoidance of doubt any action that may be in violation of the automatic stay under any Debtor Relief Law or that may effect
a forfeiture, modification or termination of property of a Defaulting Lender in violation of any Debtor Relief Law; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) shall not, except as expressly set forth herein and in the other Credit Documents, have any duty to disclose, and shall not
be liable for the failure to disclose, any information relating to any Credit Party or any of its Affiliates that is communicated to or obtained by the Person serving as the Administrative Agent or any of its Affiliates in any capacity. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Administrative Agent shall not be liable for any action taken or not taken by it (i)&nbsp;with the consent or at the request of the
Required Lenders (or such other number or percentage of the Lenders as shall be necessary, or as the Administrative Agent shall believe in good faith shall be necessary, under the circumstances as provided in Sections&nbsp;9.1 and 7.2) or
(ii)&nbsp;in the absence of its own gross negligence or willful misconduct as determined by a court of competent jurisdiction by final and nonappealable judgment. The Administrative Agent shall be deemed not to have knowledge of any Default unless
and until notice describing such Default is given to the Administrative Agent in writing by the Borrower, a Lender or an Issuing Lender. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Administrative Agent shall not be responsible for or have any duty to ascertain or inquire into (i)&nbsp;any statement, warranty or
representation made in or in connection with this Agreement or any other Credit Document, (ii)&nbsp;the contents of any certificate, report or other document delivered hereunder or thereunder or in connection herewith or therewith, (iii)&nbsp;the
performance or observance of any of the covenants, agreements or other terms or conditions set forth herein or therein or the occurrence of any Default, (iv)&nbsp;the validity, enforceability, effectiveness or genuineness of this Agreement, any
other Credit Document or any other agreement, instrument or document or (v)&nbsp;the satisfaction of any condition set forth in <U>Article IV</U> or elsewhere herein, other than to confirm receipt of items expressly required to be delivered to the
Administrative Agent. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;8.4</B> <B><U>Reliance by Administrative Agent</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Administrative Agent shall be entitled to rely upon, and shall not incur any liability for relying upon, any notice, request, certificate,
consent, statement, instrument, document or other writing (including any electronic message, Internet or intranet website posting or other distribution) believed by it to be genuine and to have been signed, sent or otherwise authenticated by the
proper Person. The Administrative Agent also may rely upon any statement made to it orally or by telephone and believed by it to have been made by the proper Person, and shall not incur any liability for relying thereon. In determining compliance
with any condition hereunder to the making of a Loan, or the issuance, extension, renewal or increase of a Letter of Credit, that by its terms must be fulfilled to the satisfaction of a Lender or an Issuing Lender, the Administrative Agent may
presume that such condition is satisfactory to such Lender or such Issuing Lender unless the Administrative Agent shall have received notice to the contrary from such Lender or such Issuing Lender prior to the making of such Loan or the issuance of
such Letter of Credit. The Administrative Agent may consult with legal counsel (who may be counsel for the Borrower), independent accountants and other experts selected by it, and shall not be liable for any action taken or not taken by it in
accordance with the advice of any such counsel, accountants or experts. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;8.5</B> <B><U>Notice of
Default</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Administrative Agent shall not be deemed to have knowledge or notice of the occurrence of any Default or Event of
Default hereunder unless the Administrative Agent has received written notice from a Lender or the Borrower referring to this Agreement, describing such Default or Event of Default and stating that such notice is
</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">81 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
a &#147;notice of default.&#148; In the event that the Administrative Agent receives such a notice, the Administrative Agent shall give prompt notice thereof to the Lenders. The Administrative
Agent shall take such action with respect to such Default or Event of Default as shall be reasonably directed by the Required Lenders; <U>provided</U>, <U>however</U>, that unless and until the Administrative Agent shall have received such
directions, the Administrative Agent may (but shall not be obligated to) take such action, or refrain from taking such action, with respect to such Default or Event of Default as it shall deem advisable in the best interests of the Lenders except to
the extent that this Agreement expressly requires that such action be taken, or not taken, only with the consent or upon the authorization of the Required Lenders, or all of the Lenders, as the case may be. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;8.6</B> <B><U><FONT STYLE="white-space:nowrap">Non-Reliance</FONT> on Administrative Agent and Other
Lenders</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each Lender and each Issuing Lender expressly acknowledges that neither the Administrative Agent nor any of its officers,
directors, employees, agents, <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">attorneys-in-fact</FONT></FONT> or affiliates has made any representation or warranty to it and that no act by the Administrative Agent hereinafter
taken, including any review of the affairs of any Credit Party, shall be deemed to constitute any representation or warranty by the Administrative Agent to any Lender. Each Lender and each Issuing Lender acknowledges that it has, independently and
without reliance upon the Administrative Agent or any other Lender or any of their Related Parties and based on such documents and information as it has deemed appropriate, made its own credit analysis and decision to enter into this Agreement. Each
Lender and each Issuing Lender also acknowledges that it will, independently and without reliance upon the Administrative Agent or any other Lender or any of their Related Parties and based on such documents and information as it shall from time to
time deem appropriate, continue to make its own decisions in taking or not taking action under or based upon this Agreement, any other Credit Document or any related agreement or any document furnished hereunder or thereunder. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;8.7</B> <B><U>Indemnification</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Lenders agree to indemnify the Administrative Agent, the Issuing Lenders and their Affiliates and their respective officers, directors,
agents and employees (to the extent not reimbursed by the Credit Parties and without limiting the obligation of the Credit Parties to do so), ratably according to their respective Commitment Percentages in effect on the date on which indemnification
is sought under this Section, from and against any and all liabilities, obligations, losses, damages, penalties, actions, judgments, suits, costs, expenses or disbursements of any kind whatsoever which may at any time (including, without limitation,
at any time following the payment of the Credit Party Obligations) be imposed on, incurred by or asserted against any such indemnitee in any way relating to or arising out of any Credit Document or any documents contemplated by or referred to herein
or therein or the transactions contemplated hereby or thereby or any action taken or omitted by any such indemnitee under or in connection with any of the foregoing; <U>provided</U>, <U>however</U>, that no Lender shall be liable for the payment of
any portion of such liabilities, obligations, losses, damages, penalties, actions, judgments, suits, costs, expenses or disbursements to the extent resulting from such indemnitee&#146;s gross negligence or willful misconduct, as determined by a
court of competent jurisdiction. The agreements in this Section shall survive the termination of this Agreement and payment of the Notes, any Reimbursement Obligation and all other amounts payable hereunder. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;8.8</B> <B><U>Administrative Agent in Its Individual Capacity</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Person serving as the Administrative Agent hereunder shall have the same rights and powers in its capacity as a Lender as any other Lender
and may exercise the same as though it were not the Administrative Agent and the term &#147;Lender&#148; or &#147;Lenders&#148; shall, unless otherwise expressly indicated or unless the context otherwise requires, include the Person serving as the
Administrative Agent hereunder in its individual capacity. Such Person and its Affiliates may accept deposits from, lend money to, own securities of, act as the financial advisor or in any other advisory capacity for and generally engage in any kind
of business with the Credit Parties or any Subsidiary or other Affiliate thereof as if such Person were not the Administrative Agent hereunder and without any duty to account therefor to the Lenders. </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">82 </P>

</DIV></Center>


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


<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"><B>Section&nbsp;8.9 <U>Successor Administrative Agent</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) The Administrative Agent may at any time give notice of its resignation to the Lenders, the Issuing Lenders and the Borrower. Upon receipt
of any such notice of resignation, the Required Lenders shall have the right to appoint a successor, which shall be a bank with an office in the United States (other than a Defaulting Lender), or an Affiliate of any such bank with an office in the
United States, and which appointment shall, provided no Event of Default exists under Section&nbsp;7.1(a) or (f), be subject to the Borrower&#146;s approval, which approval shall not be unreasonably withheld or delayed. If no such successor shall
have been so appointed by the Required Lenders, and shall have accepted such appointment, within thirty (30)&nbsp;days after the retiring Administrative Agent gives notice of its resignation (or such earlier day as shall be agreed by the Borrower
and the Required Lenders) (the &#147;<U>Resignation Effective Date</U>&#148;), then the retiring Administrative Agent may (but shall not be obligated to), on behalf of the Lenders and the Issuing Lenders, appoint a successor Administrative Agent
meeting the qualifications set forth above, which appointment shall, provided no Event of Default exists under Section&nbsp;7.1(a) or (f), be subject to the Borrower&#146;s approval, which approval shall not be unreasonably withheld or delayed.
Whether or not a successor has been appointed, such resignation shall nonetheless become effective in accordance with such notice on the Resignation Effective Date. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) If the Person serving as Administrative Agent is a Defaulting Lender pursuant to clause (d)&nbsp;of the definition thereof, the Required
Lenders may, to the extent permitted by applicable law, by notice in writing to the Borrower and such Person, remove such Person as Administrative Agent and appoint a successor, which appointment shall, provided no Event of Default exists under
Section&nbsp;7.1(a) or (f), be subject to the Borrower&#146;s approval, which approval shall not be unreasonably withheld or delayed. If no such successor shall have been so appointed by the Required Lenders and shall have accepted such appointment
within 30 days (or such earlier day as shall be agreed by the Borrower and the Required Lenders) (the &#147;<U>Removal Effective Date</U>&#148;), then such removal shall nonetheless become effective in accordance with such notice on the Removal
Effective Date. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) With effect from the Resignation Effective Date or the Removal Effective Date (as applicable) (i)&nbsp;the retiring
or removed Administrative Agent shall be discharged from its duties and obligations hereunder and under the other Credit Documents (except that in the case of any Collateral held by the Administrative Agent on behalf of the Lenders or the Issuing
Lenders under any of the Credit Documents, the retiring Administrative Agent shall continue to hold such Collateral until such time as a successor Administrative Agent is appointed) and (ii)&nbsp;all payments, communications and determinations
provided to be made by, to or through the Administrative Agent shall instead be made by or to each Lender and each Issuing Lender directly, until such time, if any, as the Required Lenders appoint a successor Administrative Agent as provided for
above. Upon the acceptance of a successor&#146;s appointment as Administrative Agent hereunder, such successor shall succeed to and become vested with all of the rights, powers, privileges and duties of the retiring or removed Administrative Agent,
and the retiring or removed Administrative Agent shall be discharged from all of its duties and obligations hereunder or under the other Credit Documents (if not already discharged therefrom as provided above in this paragraph). The fees payable by
the Borrower to a successor Administrative Agent shall be the same as those payable to its predecessor unless otherwise agreed between the Borrower and such successor. After the retiring Administrative Agent&#146;s resignation or removal hereunder
and under the other Credit Documents, the provisions of this Article and Section&nbsp;9.5 shall continue in effect for the benefit of such retiring or removed Administrative Agent, its <FONT STYLE="white-space:nowrap">sub-agents</FONT> and their
respective Related Parties in respect of any actions taken or omitted to be taken by any of them while the retiring Administrative Agent was acting as Administrative Agent. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) Any resignation by JPMCB, as Administrative Agent pursuant to this Section shall also constitute its resignation as an Issuing Lender.
Upon the acceptance of a successor&#146;s appointment as Administrative Agent hereunder, (i)&nbsp;such successor shall succeed to and become vested with all of the rights, powers, privileges and duties of JPMCB in its capacity as a retiring Issuing
Lender, (ii)&nbsp;such retiring Issuing Lender shall be discharged from all of their respective duties and obligations hereunder or under the other Credit Documents, and (iii)&nbsp;the successor Issuing Lender shall issue letters of credit in
substitution for the Letters of Credit, if any, outstanding at the time of such succession or make other arrangements satisfactory to the retiring Issuing Lender to effectively assume the obligations of such retiring Issuing Lender with respect to
such Letters of Credit. Such resignation shall not affect the validity or effectiveness of any Letter of Credit issued prior to such resignation by JPMCB as Administrative Agent. </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">83 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;8.10</B> <B><U>Guaranty Matters</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) The Lenders and each Bank Product Provider irrevocably authorize and direct the Administrative Agent to release any Guarantor from its
obligations under the applicable Guaranty if such Person ceases to be a Guarantor as a result of a transaction permitted hereunder. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b)
In connection with a termination or release pursuant to this Section, the Administrative Agent shall promptly execute and deliver to the applicable Credit Party, at the Borrower&#146;s expense, all documents that the applicable Credit Party shall
reasonably request to evidence such termination or release. Upon request by the Administrative Agent at any time, the Required Lenders will confirm in writing the Administrative Agent&#146;s authority to release any Guarantor from its obligations
under the Guaranty pursuant to this Section. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;8.11</B> <B><U>Bank Products</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Except as otherwise provided herein, no Bank Product Provider that obtains the benefits of Sections 2.8 and 7.2 or any Guaranty by virtue of
the provisions hereof or of any Guaranty shall have any right to notice of any action or to consent to, direct or object to any action hereunder or under any other Credit Document other than in its capacity as a Lender and, in such case, only to the
extent expressly provided in the Credit Documents. The Administrative Agent shall not be required to verify the payment of, or that other satisfactory arrangements have been made with respect to, Credit Party Obligations arising under Bank Products
unless the Administrative Agent has received written notice of such Credit Party Obligations, together with such supporting documentation as the Administrative Agent may request, from the applicable Bank Product Provider. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;8.12</B> <B><U>Withholding Tax</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">To the extent required by any Requirements of Law (as determined in good faith by the Administrative Agent), the Administrative Agent may
withhold from any payment to any Lender under any Credit Document an amount equivalent to any applicable withholding Tax. Without limiting or expanding the provisions of Section&nbsp;2.16, each Lender shall indemnify and hold harmless the
Administrative Agent against, and shall make payable in respect thereof within 10 days after demand therefor, any and all Taxes and any and all related losses, claims, liabilities and expenses (including fees, charges and disbursements of any
counsel for the Administrative Agent) incurred by or asserted against the Administrative Agent by the IRS or any other Governmental Authority<B> </B>as a result of the failure of the Administrative Agent to properly withhold Tax from amounts paid to
or for the account of such Lender for any reason (including because the appropriate form was not delivered or not properly executed, or because such Lender failed to notify the Administrative Agent of a change in circumstance that rendered the
exemption from, or reduction of withholding Tax ineffective). A certificate as to the amount of such payment or liability delivered to any Lender by the Administrative Agent shall be conclusive absent manifest error. Each Lender hereby authorizes
the Administrative Agent to set off and apply any and all amounts at any time owing to such Lender under this Agreement or any other Credit Document against any amount due the Administrative Agent under this Section&nbsp;8.12. The agreements in this
Section&nbsp;8.12 shall survive the resignation and/or replacement of the Administrative Agent, any assignment of rights by, or the replacement of, a Lender, the termination of the Commitments and the repayment, satisfaction or discharge of all
other Obligations. For the avoidance of doubt, the term &#147;Lender&#148; shall, for purposes of this Section&nbsp;8.12, include any Issuing Lender. </P>
<P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>ARTICLE IX </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>MISCELLANEOUS </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.1</B> <B><U>Amendments and Waivers</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Subject to Section&nbsp;2.13(b), Section&nbsp;2.22(d) and Section&nbsp;9.1(b) below, neither this Agreement nor any of the other Credit
Documents, nor any terms hereof or thereof may be amended, modified, extended, restated, replaced, or supplemented (by amendment, waiver, consent or otherwise) except in accordance with the provisions of this Section. The Required Lenders may or,
with the written consent of the Required Lenders, the Administrative Agent may, from time to time, (a)&nbsp;enter into with the Borrower written amendments, supplements or modifications </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">84 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
hereto and to the other Credit Documents for the purpose of adding any provisions to this Agreement or the other Credit Documents or changing in any manner the rights of the Lenders or of the
Borrower hereunder or thereunder or (b)&nbsp;waive or consent to the departure from, on such terms and conditions as the Required Lenders may specify in such instrument, any of the requirements of this Agreement or the other Credit Documents or any
Default or Event of Default and its consequences; <U>provided</U>, <U>however</U>, that no such amendment, supplement, modification, release, waiver or consent shall: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) reduce the amount or extend the scheduled date of maturity of any Loan or Note or any installment thereon, or reduce the
amount or stated rate of any interest or fee payable hereunder (except in connection with a waiver of interest at the increased post-default rate set forth in Section&nbsp;2.8 which shall be determined by a vote of the Required Lenders) or extend
the scheduled date of any payment thereof or increase the amount or extend the expiration date of any Lender&#146;s Commitment, in each case without the written consent of each Lender directly affected thereby; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) amend, modify or waive any provision of this Section or reduce the percentage specified in the definition of Required
Lenders or Required Facility Lenders, without the written consent of all the Lenders; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) release the Borrower or all
or substantially all of the Guarantors from obligations under the Guaranty, without the written consent of all of the Lenders and Bank Product Providers; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iv) subordinate the Loans to any other Indebtedness without the written consent of all of the Lenders; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(v) permit a Letter of Credit to have an original expiry date more than twelve (12)&nbsp;months from the date of issuance
without the consent of each of the Revolving Lenders; <U>provided</U>, that the expiry date of any Letter of Credit may be extended in accordance with the terms of Section&nbsp;2.3(a); or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(vi) permit the Borrower to assign or transfer any of its rights or obligations under this Agreement or other Credit Documents
without the written consent of all of the Lenders; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(vii) amend, modify or waive any provision of the Credit Documents
requiring consent, approval or request of the Required Lenders or Required Facility Lenders or all Lenders without the written consent of the Required Lenders or Required Facility Lenders or all the Lenders as appropriate; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(viii) amend, modify or waive the order in which Credit Party Obligations are paid or in a manner that would alter the pro rata
sharing of payments by and among the Lenders in Section&nbsp;2.11(b) or 9.7(b) without the written consent of each Lender and each Bank Product Provider directly affected thereby; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ix) amend, modify or waive any provision of <U>Article VIII</U> without the written consent of the then Administrative Agent;
or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(x) amend or modify the definition of Credit Party Obligations to delete or exclude any obligation or liability
described therein without the written consent of each Lender and each Bank Product Provider directly affected thereby; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(xi) amend the definitions of &#147;Hedging Agreement,&#148; &#147;Bank Product,&#148; or &#147;Bank Product Provider&#148;
without the consent of any Bank Product Provider<B> </B>that would be adversely affected thereby; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(xii) at any time
following the Collateral Event, release all or substantially all of the Collateral without the written consent of each Lender; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(xiii) allow the Credit Parties to Dispose of all or substantially all of their assets, without the written consent of all of
the Lenders and Bank Product Providers. </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">85 </P>

</DIV></Center>


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


<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"><U>provided</U>, <U>further</U>, that no amendment, waiver or consent affecting the rights
or duties of the Administrative Agent or any Issuing Lender under any Credit Document shall in any event be effective, unless in writing and signed by the Administrative Agent and such Issuing Lender, in addition to the Lenders required hereinabove
to take such action. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding the foregoing, any amendment that would require the approval of the Required Lenders as set forth
above but only affects the Revolving Lenders (including, for the avoidance of doubt, paragraphs (a)&nbsp;through (d) and (f)&nbsp;of Section&nbsp;4.2, insofar as they apply to the borrowing of Revolving Loans) or the Incremental Lenders of any
series shall instead require the approval of the applicable Required Facility Lenders (in addition to any other approvals that would otherwise be required). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Any such waiver, any such amendment, supplement or modification and any such release shall apply equally to each of the Lenders and shall be
binding upon the Borrower, the other Credit Parties, the Lenders, the Administrative Agent and all future holders of the Notes. In the case of any waiver, the Borrower, the other Credit Parties, the Lenders and the Administrative Agent shall be
restored to their former position and rights hereunder and under the outstanding Loans and Notes and other Credit Documents, and any Default or Event of Default waived shall be deemed to be cured and not continuing; but no such waiver shall extend
to any subsequent or other Default or Event of Default, or impair any right consequent thereon. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding any of the foregoing to
the contrary, the consent of the Borrower and the other Credit Parties shall not be required for any amendment, modification or waiver of the provisions of <U>Article VIII</U> (other than the provisions of Section&nbsp;8.9). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding any of the foregoing to the contrary, the Credit Parties and the Administrative Agent, without the consent of any Lender, may
enter into any amendment, modification or waiver of any Credit Document, or enter into any new agreement or instrument, to correct any obvious error or omission of a technical nature, in each case that is immaterial (as determined by the
Administrative Agent), in any provision of any Credit Document, if the same is not objected to in writing by the Required Lenders within five (5)&nbsp;Business Days following receipt of notice thereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding (x)&nbsp;the fact that the consent of all the Lenders or of each Lender directly affected thereby is required in certain
circumstances as set forth above or (y)&nbsp;anything to the contrary contained in this Agreement, (a)&nbsp;each Lender is entitled to vote as such Lender sees fit on any bankruptcy reorganization plan that affects the Loans, and each Lender
acknowledges that the provisions of Section&nbsp;1126(c) of the Bankruptcy Code supersedes the unanimous consent provisions set forth herein, (b)&nbsp;the Required Lenders may consent to allow a Credit Party to use cash collateral in the context of
a bankruptcy or insolvency proceeding and (c)&nbsp;no Defaulting Lender shall have any right to approve or disapprove any amendment, waiver or consent hereunder, except (i)&nbsp;that the Commitment of such Lender may not be increased or extended
without the consent of such Lender and (ii)&nbsp;to the extent such amendment, waiver or consent impacts such Defaulting Lender more than the other Lenders. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">For the avoidance of doubt and notwithstanding any provision to the contrary contained in this Section&nbsp;9.1, this Agreement may be amended
(or amended and restated) with the written consent of the Credit Parties and the Administrative Agent in accordance with Section&nbsp;2.22. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) If the Administrative Agent and the Borrower acting together identify any ambiguity, omission, mistake, typographical error or other
defect in any provision of this Agreement or any other Credit Document, then the Administrative Agent and the Borrower shall be permitted to amend, modify or supplement such provision to cure such ambiguity, omission, mistake, typographical error or
other defect, and such amendment shall become effective without any further action or consent of any other party to this Agreement. </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">86 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;9.2</B> <B><U>Notices</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Notices Generally</U>. Except in the case of notices and other communications expressly permitted to be given by telephone (and except
as provided in paragraph (b)&nbsp;below), all notices and other communications provided for herein shall be in writing and shall be delivered by hand or overnight courier service, mailed by certified or registered mail or sent by telecopier as
follows: </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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(i)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">If to the Borrower or any other Credit Party: </P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">1301 Concord Terrace </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Sunrise,
Florida 33323 </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Attention:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Chief Financial Officer and General Counsel </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Telephone:&nbsp;&nbsp;&nbsp;&nbsp;(954) <FONT STYLE="white-space:nowrap">384-0175</FONT> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Fax: &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(954)
<FONT STYLE="white-space:nowrap">384-7657</FONT> </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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(ii)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">If to the Administrative Agent: </P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">JPMorgan Chase Bank, N.A., as Administrative Agent </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">10 South Dearborn, Level&nbsp;2 </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Chicago, Illinois 60603-2300 </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Attention:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Jonathan Dowdy </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Telephone:&nbsp;&nbsp;&nbsp;&nbsp;(312) <FONT STYLE="white-space:nowrap">732-1891</FONT> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Fax:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(888) <FONT STYLE="white-space:nowrap">292-9533</FONT>
</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Email:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;jpm.agency.servicing.1@jpmchase.com </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">with a copy to: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Cahill
Gordon&nbsp;&amp; Reindel LLP </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">80 Pine Street </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">New York, New York 10005 </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Attention:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Jennifer B. Ezring </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Telephone:&nbsp;&nbsp;&nbsp;&nbsp;(212) <FONT STYLE="white-space:nowrap">701-3822</FONT> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Fax:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(212)
<FONT STYLE="white-space:nowrap">378-2415</FONT> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:13%; font-size:10pt; font-family:Times New Roman">Email:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;jezring@cahill.com </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) if to a Lender, to it at its address (or telecopier number) set forth in its Administrative Questionnaire. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notices sent by hand or overnight courier service, or mailed by certified or registered mail, shall be deemed to have been given when
received; notices sent by telecopier shall be deemed to have been given when sent (except that, if not given during normal business hours for the recipient, shall be deemed to have been given at the opening of business on the next business day for
the recipient). Notices delivered through electronic communications to the extent provided in paragraph (b)&nbsp;below, shall be effective as provided in said paragraph (b). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Electronic Communications</U>. Notices and other communications to the Lenders and the Issuing Lenders hereunder may be delivered or
furnished by electronic communication (including <FONT STYLE="white-space:nowrap">e-mail</FONT> and Internet or intranet websites) pursuant to procedures approved by the Administrative Agent, <U>provided</U> that the foregoing shall not apply to
notices to any Lender or any Issuing Lender pursuant to <U>Article II</U> if such Lender or such Issuing Lender, as applicable, has notified the Administrative Agent that it is incapable of receiving notices under such Article by electronic
communication. The Administrative Agent or the Borrower may, in its discretion, agree to accept notices and other communications to it hereunder by electronic communications pursuant to procedures approved by it, <U>provided</U> that approval of
such procedures may be limited to particular notices or communications. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Unless the Administrative Agent otherwise prescribes,
(i)&nbsp;notices and other communications sent to an <FONT STYLE="white-space:nowrap">e-mail</FONT> address shall be deemed received upon the sender&#146;s receipt of an acknowledgement from the intended recipient (such as by the &#147;return
receipt requested&#148; function, as available, return <FONT STYLE="white-space:nowrap">e-mail</FONT> or other written acknowledgement), <U>provided</U> that if such notice or other communication is not sent during the normal business hours of the
recipient, such notice or communication shall be deemed to have been sent at the opening of business on the next business day for the recipient, and (ii)&nbsp;notices or communications posted to an Internet or intranet website shall be deemed
received upon the deemed receipt by the intended recipient at its <FONT STYLE="white-space:nowrap">e-mail</FONT> address as described in the foregoing clause&nbsp;(i) of notification that such notice or communication is available and identifying the
website address therefor. </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">87 </P>

</DIV></Center>


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


<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">(c) <U>Change of Address, Etc</U>. Any party hereto may change its address or telecopier
number for notices and other communications hereunder by notice to the other parties hereto. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) <U>Platform</U>. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) Each Credit Party agrees that the Administrative Agent may make the Communications available to the Lenders by posting the Communications
on Intralinks or a substantially similar electronic transmission system (the &#147;<U>Platform</U>&#148;). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) The Platform is provided
&#147;as is&#148; and &#147;as available.&#148; The Agent Parties (as defined below) do not warrant the adequacy of the Platform and expressly disclaim liability for errors or omissions in the Communications effected thereby. No warranty of any
kind, express, implied or statutory, including, without limitation, any warranty of merchantability, fitness for a particular purpose, <FONT STYLE="white-space:nowrap">non-infringement</FONT> of third-party rights or freedom from viruses or other
code defects, is made by any Agent Party in connection with the Communications or the Platform. In no event shall the Administrative Agent or any of its affiliates or any of their respective officers, directors, employees, agents, advisors or
representatives (collectively, &#147;<U>Agent Parties</U>&#148;) have any liability to the Credit Parties, any Lender or any other Person or entity for damages of any kind, including, without limitation, direct or indirect, special, incidental or
consequential damages, losses or expenses (whether in tort, contract or otherwise) arising out of any Credit Party&#146;s or the Administrative Agent&#146;s transmission of Communications through the Platform, unless determined by a court of
competent jurisdiction by final and nonappealable judgment to have resulted from the gross negligence, bad faith or willful misconduct of an Agent Party or from any material breach by an Agent Party of the obligations owing by it to the Credit
Parties under this Agreement or the other Credit Documents. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.3</B> <B><U>No Waiver; Cumulative
Remedies</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">No failure to exercise and no delay in exercising, on the part of the Administrative Agent or any Lender, any right,
remedy, power or privilege hereunder shall operate as a waiver thereof; nor shall any single or partial exercise of any right, remedy, power or privilege hereunder preclude any other or further exercise thereof or the exercise of any other right,
remedy, power or privilege. The rights, remedies, powers and privileges herein provided are cumulative and not exclusive of any rights, remedies, powers and privileges provided by law. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.4</B> <B><U>Survival of Representations and Warranties</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">All representations and warranties made hereunder and in any document, certificate or statement delivered pursuant hereto or in connection
herewith shall survive the execution and delivery of this Agreement and the Notes and the making of the Loans; <U>provided</U> that all such representations and warranties shall terminate on the date upon which the Commitments have been terminated
and all amounts owing hereunder and under any Notes have been paid in full. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.5</B> <B><U>Payment of
Expenses; Indemnity</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Costs and Expenses</U>. The Credit Parties shall pay (i)&nbsp;all reasonable and documented <FONT
STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> expenses incurred by the Administrative Agent and the Arrangers (including the reasonable and documented fees, charges and disbursements of one external counsel
for the Administrative Agent and the Arrangers, taken as a whole, and one external local counsel for the Administrative Agent and the Arrangers, taken as a whole, in each jurisdiction if required), in connection with the syndication of the credit
facilities provided for herein, the preparation, negotiation, execution, delivery and administration of this Agreement and the other Credit Documents or any amendments, modifications or waivers of the provisions hereof or thereof (whether or not the
transactions contemplated hereby or thereby shall be consummated), (ii)&nbsp;all reasonable and documented <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> expenses incurred by any Issuing Lender in
connection with the issuance, amendment, renewal or extension of any Letter of Credit or any demand for payment thereunder and (iii)&nbsp;all reasonable and documented
<FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> fees and expenses incurred by the Administrative Agent, any Lender, any Issuing Lender (including the reasonable and documented fees, charges and
disbursements of one external counsel for the Administrative Agent, the Lenders and the Issuing Lenders, taken as a whole, and one external local counsel for the Administrative Agent, the Lenders and the Issuing Lenders, taken as a whole (and to the
extent any such person determines, after consultation with legal </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">88 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
counsel, that an actual or potential conflict may require use of separate counsel by such person, separate legal counsel (including separate local counsel) for such person)) in connection with
the enforcement or protection of its rights (A)&nbsp;in connection with this Agreement and the other Credit Documents, including its rights under this Section, or (B)&nbsp;in connection with the Loans made or Letters of Credit issued hereunder,
including all such <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> expenses incurred during any workout, restructuring or negotiations in respect of such Loans or Letters of Credit. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Indemnification by the Credit Parties</U>. The Credit Parties shall indemnify the Administrative Agent (and any <FONT
STYLE="white-space:nowrap">sub-agent</FONT> thereof), each Lender, each Issuing Lender, and each Related Party of any of the foregoing Persons (each such Person being called an &#147;<U>Indemnitee</U>&#148;) against, and hold each Indemnitee
harmless from, any and all losses, claims, penalties, damages, liabilities and related expenses (including the reasonable and documented fees, charges and disbursements of one external counsel for the Indemnitees, taken as a whole, and one external
local counsel for the Indemnitees, taken as a whole, in each applicable jurisdiction if required (and to the extent an Indemnitee determines, after consultation with legal counsel, that an actual or potential conflict may require use of separate
counsel by such Indemnitee, separate legal counsel (including separate local counsel) for such Indemnitee)), incurred by any Indemnitee or asserted against any Indemnitee by any third party or by the Borrower or any other Credit Party arising out
of, in connection with, or as a result of (i)&nbsp;the execution or delivery of this Agreement, any other Credit Document or any agreement or instrument contemplated hereby or thereby, the performance by the parties hereto of their respective
obligations hereunder or thereunder or the consummation of the transactions contemplated hereby or thereby, (ii)&nbsp;any Loan or Letter of Credit or the use or proposed use of the proceeds therefrom (including any refusal by any Issuing Lender to
honor a demand for payment under a Letter of Credit if the documents presented in connection with such demand do not strictly comply with the terms of such Letter of Credit), (iii)&nbsp;any actual or alleged presence or release of Materials of
Environmental Concern on or from any property owned or operated by any Credit Party or any of its Subsidiaries, or any liability under Environmental Law related in any way to any Credit Party or any of its Subsidiaries, or (iv)&nbsp;any actual or
prospective claim, litigation, investigation or proceeding relating to any of the foregoing, whether based on contract, tort or any other theory, whether brought by a third party or by the Borrower or any other Credit Party, and regardless of
whether any Indemnitee is a party thereto, <U>provided</U> that such indemnity shall not, as to any Indemnitee, be available to the extent that such losses, claims, damages, liabilities or related expenses (A)&nbsp;are determined by a court of
competent jurisdiction by final and nonappealable judgment to have resulted from the bad faith, gross negligence or willful misconduct of such Indemnitee, (B)&nbsp;result from a claim brought by the Borrower or any other Credit Party against such
Indemnitee for material breach of such Indemnitee&#146;s obligations hereunder or under any other Credit Document, if the Borrower or such Credit Party has obtained a final <FONT STYLE="white-space:nowrap">non-appealable</FONT> judgment in its favor
on such claim as determined by a court of competent jurisdiction, (C)&nbsp;arise from disputes arising solely among Indemnitees that do not involve any act or omission by any Credit Party or their respective Affiliates and are unrelated to any
dispute involving the Administrative Agent in its capacity as such, or any claim by, the Administrative Agent, any Lender or any Issuing Lender against any Credit Party or its Affiliates, or (D)&nbsp;are payable as a result of a settlement agreement
related to the foregoing effected without the written consent of the Borrower (which consent shall not to be unreasonably withheld or delayed); provided that (i)&nbsp;such consent shall be deemed given in the event that the Borrower has not objected
thereto in writing within 15 days after receiving written notice thereof, (ii)&nbsp;such consent shall not be required if any Credit Party has defaulted under its indemnification obligations (including obligations to indemnify the Indemnitees for
legal fees and expenses related to such matter as requested by an Indemnitee from time to time) and (iii)&nbsp;no such consent shall be required if there is a final judgment against an Indemnitee in any proceeding; <U>provided</U>, further however,
that such Indemnitee shall promptly refund any amount to the extent that there is a final, <FONT STYLE="white-space:nowrap">non-appealable</FONT> judicial determination that such Indemnitee was not entitled to indemnification or contribution rights
with respect to such payment pursuant to the express terms of this Section&nbsp;9.5(b). This Section&nbsp;9.5(b) shall not apply with respect to Taxes other than any Taxes that represent losses, claims, damages, etc. arising from any <FONT
STYLE="white-space:nowrap">non-Tax</FONT> claim. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Reimbursement by Lenders</U>. To the extent that the Credit Parties for any
reason fail to indefeasibly pay any amount required under paragraph (a)&nbsp;or (b) of this Section to be paid by it to the Administrative Agent (or any <FONT STYLE="white-space:nowrap">sub-agent</FONT> thereof), any Issuing Lender or any Related
Party of any of the foregoing, each Lender severally agrees to pay to the Administrative Agent (or any such <FONT STYLE="white-space:nowrap">sub-agent),</FONT> such Issuing Lender or such Related Party, as the case may be, such Lender&#146;s
Commitment Percentage (determined as of the time that the applicable unreimbursed expense or indemnity payment is sought) of such unpaid amount, <U>provided</U> that the unreimbursed expense or indemnified loss, claim, damage, liability or related
expense, as the case may be, was incurred by or asserted against the Administrative Agent (or any such <FONT STYLE="white-space:nowrap">sub-agent),</FONT> any Issuing Lender in its capacity as such, or against any Related Party of any of the
foregoing acting for the Administrative Agent (or any such <FONT STYLE="white-space:nowrap">sub-agent)</FONT> or any Issuing Lender in connection with such capacity. </P> <P STYLE="font-size:12pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</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">89 </P>

</DIV></Center>


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


<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">(d) <U>Waiver of Consequential Damages, Etc</U>. To the fullest extent permitted by
applicable law, none of the parties hereto or any Indemnitee shall assert, and each of them hereby waives, any claim against any other Person, on any theory of liability, for special, indirect, consequential or punitive damages (as opposed to direct
or actual damages) arising out of, in connection with, or as a result of, this Agreement, any other Credit Document or any agreement or instrument contemplated hereby, the transactions contemplated hereby or thereby, any Loan or Letter of Credit or
the use of the proceeds thereof; <U>provided</U>, that such waiver shall not apply to any parties or any Indemnitee&#146;s right to indemnification hereunder for losses, claims, penalties, damages, liabilities and related expenses incurred by any
party or Indemnitee as a result of a claim by any third party. No Indemnitee referred to in paragraph&nbsp;(b) above shall be liable for any damages arising from the use by unintended recipients of any information or other materials distributed by
it through telecommunications, electronic or other information transmission systems in connection with this Agreement or the other Credit Documents or the transactions contemplated hereby or thereby other than for direct or actual damages resulting
from the bad faith, gross negligence or willful misconduct of such Indemnitee as determined by a final and nonappealable judgment of a court of competent jurisdiction. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) <U>Payments</U>. All amounts due under this Section shall be payable promptly/not later than five (5)&nbsp;Business Days after written
demand therefor. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) <U>Survival</U>. The agreements contained in this Section shall survive the resignation of the Administrative Agent
and the replacement of any Issuing Lender, the replacement of any Lender, the termination of the Commitments and the repayment, satisfaction or discharge of the Credit Party Obligations. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.6</B> <B><U>Successors and Assigns; Participations</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Successors and Assigns Generally</U>. The provisions of this Agreement shall be binding upon and inure to the benefit of the parties
hereto and their respective successors and assigns permitted hereby, except that neither the Borrower nor any other Credit Party may assign or otherwise transfer any of its rights or obligations hereunder without the prior written consent of the
Administrative Agent and each Lender and no Lender may assign or otherwise transfer any of its rights or obligations hereunder except (i)&nbsp;to an assignee in accordance with the provisions of paragraph (b)&nbsp;of this Section, (ii)&nbsp;by way
of participation in accordance with the provisions of paragraph (d)&nbsp;of this Section or (iii)&nbsp;by way of pledge or assignment of a security interest subject to the restrictions of paragraph (f)&nbsp;of this Section (and any other attempted
assignment or transfer by any party hereto shall be null and void). Nothing in this Agreement, expressed or implied, shall be construed to confer upon any Person (other than the parties hereto, their respective successors and assigns permitted
hereby, Participants to the extent provided in paragraph (d)&nbsp;of this Section and, to the extent expressly contemplated hereby, the Related Parties of each of the Administrative Agent and the Lenders) any legal or equitable right, remedy or
claim under or by reason of this Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Assignments by Lenders</U>. Any Lender may at any time assign to one or more Eligible
Assignees all or a portion of its rights and obligations under this Agreement (including all or a portion of its Commitment and the Loans at the time owing to it); <U>provided</U> that any such assignment shall be subject to the following
conditions: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) <U>Minimum Amounts</U>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(A) in the case of an assignment of the entire remaining amount of the assigning Lender&#146;s Commitment and the Loans at the
time owing to it or in the case of an assignment to a Lender, an Affiliate of a Lender or an Approved Fund, no minimum amount need be assigned; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(B) in any case not described in paragraph (b)(i)(A) of this Section, the aggregate amount of the Commitment (which for this
purpose includes Loans outstanding thereunder) or, if the applicable Commitment is not then in effect, the principal outstanding balance of the Loans of the assigning Lender subject to each such assignment (determined as of the date the Assignment
and Assumption with respect to </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">90 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
such assignment is delivered to the Administrative Agent or, if &#147;Trade Date&#148; is specified in the Assignment and Assumption, as of the Trade Date) shall not be less than $5,000,000
(<U>provided</U>, <U>however</U>, that simultaneous assignments shall be aggregated in respect of a Lender and its Approved Funds), unless each of the Administrative Agent and, so long as no Event of Default has occurred and is continuing, the
Borrower otherwise consents (each such consent not to be unreasonably withheld or delayed). </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) <U>Proportionate
Amounts</U>. Each partial assignment shall be made as an assignment of a proportionate part of all the assigning Lender&#146;s rights and obligations under this Agreement with respect to the Loan or the Commitment assigned, except that this clause
(ii)&nbsp;shall not prohibit any Lender from assigning all or a portion of its rights and obligations among separate Facilities on a <FONT STYLE="white-space:nowrap">non-pro</FONT> rata basis. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) <U>Required Consents</U>. No consent shall be required for any assignment except to the extent required by
paragraph&nbsp;(b)(i)(B) of this Section and, in addition: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(A) the consent of the Borrower (such consent not to be
unreasonably withheld or delayed) shall be required unless (x)&nbsp;an Event of Default under Section&nbsp;7.1(a) or (f)&nbsp;has occurred and is continuing at the time of such assignment or (y)&nbsp;such assignment is to a Lender, an Affiliate of a
Lender or an Approved Fund; <U>provided</U> that the Borrower will be deemed to have consented to any assignment to which it has not objected within ten (10)&nbsp;Business Days after receipt of a request for consent to such assignment; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(B) the consent of the Administrative Agent (such consent not to be unreasonably withheld or delayed) shall be required for
assignments in respect of a Revolving Commitment if such assignment is to a Person that is not a Lender with a Commitment, an Affiliate of such Lender or an Approved Fund with respect to such Lender; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(C) the consent of the Issuing Lenders (such consent not to be unreasonably withheld or delayed) shall be required for
assignments in respect of a Revolving Commitment. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iv) <U>Assignment and Assumption</U>. The parties to each assignment
shall execute and deliver to the Administrative Agent an Assignment and Assumption, together with a processing and recordation fee of $3,500; <U>provided</U> that only one (1)&nbsp;such fee shall be payable in respect of simultaneous assignments by
a Lender and its Approved Funds), and the assignee, if it is not a Lender, shall deliver to the Administrative Agent an Administrative Questionnaire. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(v) <U>No Assignment to Certain Persons</U>. No such assignment shall be made to any Person that is not an Eligible Assignee.
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(vi) <U>Certain Additional Payments</U>. In connection with any assignment of rights and obligations of any Defaulting
Lender hereunder, no such assignment shall be effective unless and until, in addition to the other conditions thereto set forth herein, the parties to the assignment shall make such additional payments to the Administrative Agent in an aggregate
amount sufficient, upon distribution thereof as appropriate (which may be outright payment, purchases by the assignee of participations or subparticipations, or other compensating actions, including funding, with the consent of the Borrower and the
Administrative Agent, the applicable pro rata share of Loans previously requested but not funded by the Defaulting Lender, to each of which the applicable assignee and assignor hereby irrevocably consent), to (A)&nbsp;pay and satisfy in full all
payment liabilities then owed by such Defaulting Lender to the Administrative Agent or any Lender hereunder (and interest accrued thereon), and (B)&nbsp;acquire (and fund as appropriate) its full pro rata share of all Loans and participations in
Letters of Credit in accordance with its Revolving Commitment Percentage in the case of Revolving Lenders or its applicable Commitment Percentage in the case of Incremental Lenders. Notwithstanding the foregoing, in the event that any assignment of
rights and obligations of any Defaulting Lender hereunder shall become effective under applicable Law without compliance with the provisions of this paragraph, then the assignee of such interest shall be deemed to be a Defaulting Lender for all
purposes of this Agreement until such compliance occurs. </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">91 </P>

</DIV></Center>


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


<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">Subject to acceptance and recording thereof by the Administrative Agent pursuant to
paragraph (c)&nbsp;of this Section, from and after the effective date specified in each Assignment and Assumption, the assignee thereunder shall be a party to this Agreement and, to the extent of the interest assigned by such Assignment and
Assumption, have the rights and obligations of a Lender under this Agreement, and the assigning Lender thereunder shall, to the extent of the interest assigned by such Assignment and Assumption, be released from its obligations under this Agreement
(and, in the case of an Assignment and Assumption covering all of the assigning Lender&#146;s rights and obligations under this Agreement, such Lender shall cease to be a party hereto) but shall continue to be entitled to the benefits of Sections
2.14 and 9.5<I> </I>with respect to facts and circumstances occurring prior to the effective date of such assignment. Any assignment or transfer by a Lender of rights or obligations under this Agreement that does not comply with this paragraph shall
be treated for purposes of this Agreement as a sale by such Lender of a participation in such rights and obligations in accordance with paragraph (d)&nbsp;of this Section. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Register</U>. The Administrative Agent, acting solely for this purpose as a <FONT STYLE="white-space:nowrap">non-fiduciary</FONT> agent
of the Borrower, shall maintain at one of its offices in Charlotte, North Carolina a copy of each Assignment and Assumption delivered to it and a register for the recordation of the names and addresses of the Lenders, and the Commitments of, and
principal amounts (and related interest amounts) of the Loans owing to, each Lender pursuant to the terms hereof from time to time (the &#147;<U>Register</U>&#148;). The entries in the Register shall be conclusive absent manifest error, and the
Borrower, the Administrative Agent and the Lenders shall treat each Person whose name is recorded in the Register pursuant to the terms hereof as a Lender hereunder for all purposes of this Agreement, notwithstanding notice to the contrary. The
Register shall be available for inspection by the Borrower and any Lender, at any reasonable time and from time to time upon reasonable prior notice. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) <U>Participations</U>. Any Lender may at any time, without the consent of, or notice to, the Borrower or the Administrative Agent, sell
participations to any Person (other than a natural person or any Credit Party or any Credit Party&#146;s Affiliates or Subsidiaries) (each, a &#147;<U>Participant</U>&#148;) in all or a portion of such Lender&#146;s rights and/or obligations under
this Agreement (including all or a portion of its Commitment and/or the Loans owing to it); <U>provided</U> that (i)&nbsp;such Lender&#146;s obligations under this Agreement shall remain unchanged, (ii)&nbsp;such Lender shall remain solely
responsible to the other parties hereto for the performance of such obligations and (iii)&nbsp;the Borrower, the Administrative Agent, the Issuing Lenders and the other Lenders shall continue to deal solely and directly with such Lender in
connection with such Lender&#146;s rights and obligations under this Agreement. For the avoidance of doubt, each Lender shall be responsible for the indemnity under Section&nbsp;9.5(c)<B> </B>with respect to any payments made by such Lender to its
Participant&nbsp;(s). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Any agreement or instrument pursuant to which a Lender sells such a participation shall provide that such Lender
shall retain the sole right to enforce this Agreement and to approve any amendment, modification or waiver of any provision of this Agreement; <U>provided</U> that such agreement or instrument may provide that such Lender will not, without the
consent of the Participant, agree to any amendment, modification or waiver that affects such Participant. Subject to paragraph (e)&nbsp;of this Section, the Borrower agrees that each Participant shall be entitled to the benefits of Sections 2.14 and
2.16 (subject to the requirements and limitations of such Sections and Section&nbsp;2.19, and it being understood that the documentation required under Section&nbsp;2.16(e) and (f)&nbsp;shall be delivered solely to the participating Lender) to the
same extent as if it were a Lender and had acquired its interest by assignment pursuant to paragraph (b)&nbsp;of this Section. To the extent permitted by law, each Participant also shall be entitled to the benefits of Section&nbsp;9.7<I> </I>as
though it were a Lender, provided such Participant agrees to be subject to Section&nbsp;2.11<I> </I>as though it were a Lender. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each
Lender that sells a participation shall, acting solely for this purpose as an agent of the Borrower, maintain a register on which it enters the name and address of each Participant and the principal amounts (and related interest amounts) of each
Participant&#146;s interest in the Loans or other obligations under the Credit Documents (the &#147;<U>Participant Register</U>&#148;); <U>provided</U> that no Lender shall have any obligation to disclose all or any portion of the Participant
Register to any Person (including the identity of any Participant or any information relating to a Participant&#146;s interest in any commitments, loans, letters of credit or its other obligations under any Credit Document) except to the extent that
such disclosure is necessary to establish that such commitment, loan, letter of credit or other obligation is in registered form under <FONT STYLE="white-space:nowrap">Section&nbsp;5f.103-1(c)</FONT> of the United States Treasury Regulations. The
entries in the Participant Register shall be conclusive absent manifest error, and such Lender shall treat each Person whose name is recorded in the Participant Register as the owner of such participation for all purposes of this Agreement
notwithstanding any notice to the contrary. </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">92 </P>

</DIV></Center>


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


<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">(e) <U>Limitations upon Participant Rights</U>. A Participant shall not be entitled to
receive any greater payment under Sections 2.14 and 2.16 than the applicable Lender would have been entitled to receive with respect to the participation sold to such Participant, unless the sale of the participation to such Participant is made with
the Borrower&#146;s prior written consent (not to be unreasonably withheld or delayed). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) <U>Certain Pledges</U>. Any Lender may at any
time pledge or assign a security interest in all or any portion of its rights under this Agreement to secure obligations of such Lender, including any pledge or assignment to secure obligations to a Federal Reserve Bank; <U>provided</U> that no such
pledge or assignment shall release such Lender from any of its obligations hereunder or substitute any such pledgee or assignee for such Lender as a party hereto. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.7</B> <B><U>Right of Setoff; Sharing of Payments</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>(a)</B> If an Event of Default shall have occurred and be continuing, each Lender, each Issuing Lender and each of their respective
Affiliates is hereby authorized at any time and from time to time, to the fullest extent permitted by applicable law, to set off and apply any and all deposits (general or special, time or demand, provisional or final, in whatever currency) at any
time held and other obligations (in whatever currency) at any time owing by such Lender, such Issuing Lender or any such Affiliate to or for the credit or the account of the Borrower or any other Credit Party against any and all of the obligations
of the Borrower or such Credit Party now or hereafter existing under this Agreement or any other Credit Document to such Lender or such Issuing Lender, irrespective of whether or not such Lender or such Issuing Lender shall have made any demand
under this Agreement or any other Credit Document and although such obligations of the Borrower or such Credit Party may be contingent or unmatured or are owed to a branch, office or affiliate of such Lender or such Issuing Lender different from the
branch, office or Affiliate holding such deposit or obligated on such indebtedness; <U>provided</U> that in the event that any Defaulting Lender shall exercise any such right of setoff, (i)&nbsp;all amounts so set off shall be paid over immediately
to the Administrative Agent for further application in accordance with the provisions of Section&nbsp;2.21 and, pending such payment, shall be segregated by such Defaulting Lender from its other funds and deemed held in trust for the benefit of the
Administrative Agent, the Issuing Lenders and the other Lenders, and (ii)&nbsp;the Defaulting Lender shall provide promptly to the Administrative Agent a statement describing in reasonable detail the Credit Party Obligations owing to such Defaulting
Lender as to which it exercised such right of setoff. The rights of each Lender, each Issuing Lender and their respective Affiliates under this Section are in addition to other rights and remedies (including other rights of setoff) that such Lender,
such Issuing Lender or their respective Affiliates may have. Each Lender and each Issuing Lender agrees to notify the Borrower and the Administrative Agent promptly after any such setoff and application, <U>provided</U> that the failure to give such
notice shall not affect the validity of such setoff and application. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) If any Lender shall, by exercising any right of setoff or
counterclaim or otherwise, obtain payment in respect of any principal of or interest on any of its Loans or other obligations hereunder resulting in such Lender&#146;s receiving payment of a proportion of the aggregate amount of its Loans and
accrued interest thereon or other such obligations greater than its <U>pro</U> <U>rata</U> share thereof as provided herein, then the Lender receiving such greater proportion shall (i)&nbsp;notify the Administrative Agent of such fact, and
(ii)&nbsp;purchase (for cash at face value) participations in the Loans and such other obligations of the other Lenders, or make such other adjustments as shall be equitable, so that the benefit of all such payments shall be shared by the Lenders
ratably in accordance with the aggregate amount of principal of and accrued interest on their respective Loans and other amounts owing them, <U>provided</U> that: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(A) if any such participations are purchased and all or any portion of the payment giving rise thereto is recovered, such
participations shall be rescinded and the purchase price restored to the extent of such recovery, without interest; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(B) the provisions of this paragraph shall not be construed to apply to (x)&nbsp;any payment made by the Borrower pursuant to
and in accordance with the express terms of this Agreement (including the application of funds arising from the existence of a Defaulting Lender), (y) any payment obtained by a Lender as consideration for the assignment of or sale of a participation
in any of its Loans or participations in Letters of Credit to any assignee or participant, other than to any Credit Party or any Subsidiary thereof (as to which the provisions of this paragraph shall apply) or (z)&nbsp;any amounts received by any
Issuing Lender to secure the obligations of a Defaulting Lender to fund risk participations hereunder. </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">93 </P>

</DIV></Center>


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


<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">(c) Each Credit Party consents to the foregoing and agrees, to the extent it may effectively
do so under applicable law, that any Lender acquiring a participation pursuant to the foregoing arrangements may exercise against each Credit Party rights of setoff and counterclaim with respect to such participation as fully as if such Lender were
a direct creditor of each Credit Party in the amount of such participation. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.8</B> <B><U>Table of Contents
and Section Headings</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The table of contents and the Section and subsection headings herein are intended for convenience only and
shall be ignored in construing this Agreement. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.9</B> <B><U>Counterparts; Integration; Effectiveness;
Electronic Execution</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Counterparts; Integration; Effectiveness</U>. This Agreement may be executed in counterparts (and by
different parties hereto in different counterparts), each of which shall constitute an original, but all of which when taken together shall constitute a single contract. This Agreement and the other Credit Documents, and any separate letter
agreements with respect to fees payable to the Administrative Agent, the Issuing Lenders or any Arranger constitute the entire contract among the parties relating to the subject matter hereof and supersede any and all previous agreements and
understandings, oral or written, relating to the subject matter hereof. Except as provided in Section&nbsp;4.1, this Agreement shall become effective when it shall have been executed by the Administrative Agent and when the Administrative Agent
shall have received counterparts hereof that, when taken together, bear the signatures of each of the other parties hereto. Delivery of an executed signature page (counterpart or otherwise) of this Agreement or any Credit Document, or any
certificates executed in connection herewith or therewith by telecopy or email shall be effective as if delivered manually. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b)
<U>Electronic Execution of Assignments</U>. The words &#147;execution,&#148; &#147;signed,&#148; &#147;signature,&#148; and words of like import in any Assignment and Assumption shall be deemed to include electronic signatures or the keeping of
records in electronic form, each of which shall be of the same legal effect, validity or enforceability as a manually executed signature or the use of a paper-based recordkeeping system, as the case may be, to the extent and as provided for in any
applicable law, including the Federal Electronic Signatures in Global and National Commerce Act, the New York State Electronic Signatures and Records Act, or any other similar state laws based on the Uniform Electronic Transactions Act;
<U>provided</U> that nothing herein shall require the Administrative Agent to accept electronic signatures in any form or format without its prior written consent. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.10</B> <B><U>Severability</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Any provision of this Agreement which is prohibited or unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective to the
extent of such prohibition or unenforceability without invalidating the remaining provisions hereof, and any such prohibition or unenforceability in any jurisdiction shall not invalidate or render unenforceable such provision in any other
jurisdiction. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.11</B> <B><U>Integration</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">This Agreement and the other Credit Documents represent the agreement of the Borrower, the other Credit Parties, the Administrative Agent and
the Lenders with respect to the subject matter hereof, and there are no promises, undertakings, representations or warranties by the Administrative Agent, the Borrower, the other Credit Parties, or any Lender relative to the subject matter hereof
not expressly set forth or referred to herein or therein. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.12</B> <B><U>Governing Law</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">This Agreement shall be governed by, and construed in accordance with, the law of the State of New York without regard to its conflicts of law
principals that would cause the law of another jurisdiction to apply (other than Sections <FONT STYLE="white-space:nowrap">5-1401</FONT> and <FONT STYLE="white-space:nowrap">5-1402</FONT> of The New York General Obligations Law). </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">94 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;9.13</B> <B><U>Consent to Jurisdiction; Service of Process and
Venue</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) <U>Consent to Jurisdiction</U>. The Borrower and each other Credit Party irrevocably and unconditionally submits, for
itself and its property, to the nonexclusive jurisdiction of the Supreme Court of New York County, New York, the United States District Court for the Southern District of New York, and any appellate court from any thereof, in any action or
proceeding arising out of or relating to this Agreement or any other Credit Document, or for recognition or enforcement of any judgment, and each of the parties hereto irrevocably and unconditionally agrees that all claims in respect of any such
action or proceeding may be heard and determined in such New York<B> </B>sitting State court or, to the fullest extent permitted by applicable law, in such Federal court. Each of the parties hereto agrees that a final judgment in any such action or
proceeding shall be conclusive and may be enforced in other jurisdictions by suit on the judgment or in any other manner provided by law. Nothing in this Agreement or in any other Credit Document shall affect any right that the Administrative Agent,
any Lender or any Issuing Lender may otherwise have to bring any action or proceeding relating to this Agreement or any other Credit Document against the Borrower or any other Credit Party or its properties in the courts of any jurisdiction. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) <U>Service of Process</U>. Each party hereto irrevocably consents to service of process in the manner provided for notices in
Section&nbsp;9.2. Nothing in this Agreement will affect the right of any party hereto to serve process in any other manner permitted by applicable law. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) <U>Venue</U>. The Borrower and each other Credit Party irrevocably and unconditionally waives, to the fullest extent permitted by
applicable law, any objection that it may now or hereafter have to the laying of venue of any action or proceeding arising out of or relating to this Agreement or any other Credit Document in any court referred to in paragraph (a)&nbsp;of this
Section. Each of the parties hereto hereby irrevocably waives, to the fullest extent permitted by applicable law, the defense of an inconvenient forum to the maintenance of such action or proceeding in any such court. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.14</B> <B><U>Confidentiality</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of the Administrative Agent, the Arrangers, the Lenders and the Issuing Lenders agree to maintain the confidentiality of the Information
(as defined below), except that Information may be disclosed (a)&nbsp;to its Affiliates and to its and its Affiliates&#146; respective partners, directors, officers, employees, agents, advisors and other representatives (it being understood that the
Persons to whom such disclosure is made will be informed of the confidential nature of such Information and instructed to keep such Information confidential), (b)&nbsp;to the extent requested by any regulatory authority purporting to have
jurisdiction over it (including any self-regulatory authority, such as the National Association of Insurance Commissioners), (c)&nbsp;to the extent required by applicable laws or regulations or by any subpoena or similar legal process, (d)&nbsp;to
any other party hereto, (e)&nbsp;in connection with the exercise of any remedies hereunder, under any other Credit Document or Bank Product or any action or proceeding relating to this Agreement, any other Credit Document or Bank Product or the
enforcement of rights hereunder or thereunder, (f)&nbsp;subject to an agreement containing provisions substantially the same as those of this Section, to any assignee of or Participant in, or any prospective assignee of or Participant in, any of its
rights or obligations under this Agreement, (g)&nbsp;to (i)&nbsp;any actual or prospective counterparty (or its advisors) to any swap or derivative transaction relating to the Borrower and its obligations, (ii)&nbsp;an investor or prospective
investor in securities issued by an Approved Fund that also agrees that Information shall be kept confidential and used solely for the purpose of evaluating an investment in such securities issued by the Approved Fund, (iii)&nbsp;a trustee,
collateral manager, servicer, backup servicer, noteholder or secured party in connection with the administration, servicing and reporting on the assets serving as collateral for securities issued by an Approved Fund, or (iv)&nbsp;a nationally
recognized rating agency that requires access to information regarding the Credit Parties, the Loans and Credit Documents in connection with ratings issued in respect of securities issued by an Approved Fund (in each case, it being understood that
the Persons to whom such disclosure is made will be informed of the confidential nature of such information and instructed to keep such information confidential), (h)&nbsp;with the consent of the Borrower or (i)&nbsp;to the extent such Information
(x)&nbsp;becomes publicly available other than as a result of a breach of this Section or (y)&nbsp;becomes available to the Administrative Agent, any Lender, any Issuing Lender or any of their respective Affiliates on a nonconfidential basis from a
source other than the Borrower. </P> <P STYLE="font-size:12pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">95 </P>

</DIV></Center>


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


<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">For purposes of this Section, &#147;<U>Information</U>&#148; means all information received
from any Credit Party or any of its Subsidiaries relating to any Credit Party or any of its Subsidiaries or any of their respective businesses, other than any such information that is available to the Administrative Agent, any Lender or any Issuing
Lender on a nonconfidential basis prior to disclosure by any Credit Party or any of its Subsidiaries; <U>provided</U> that, in the case of information received from any Credit Party or any of its Subsidiaries after the date hereof, such information
is clearly identified at the time of delivery as confidential. Any Person required to maintain the confidentiality of Information as provided in this Section shall be considered to have complied with its obligation to do so if such Person has
exercised the same degree of care to maintain the confidentiality of such Information as such Person would accord to its own confidential information. Each Lender acknowledges that federal law prohibits the purchase or sale of any of the
Borrower&#146;s securities while in possession of material <FONT STYLE="white-space:nowrap">non-public</FONT> information. Each of the Administrative Agent and the Lenders acknowledges that (a)&nbsp;the Information may include material <FONT
STYLE="white-space:nowrap">non-public</FONT> information concerning the Credit Parties and their Subsidiaries, as the case may be, (b)&nbsp;it has developed compliance procedures regarding the use of material
<FONT STYLE="white-space:nowrap">non-public</FONT> information and (c)&nbsp;it will handle such material <FONT STYLE="white-space:nowrap">non-public</FONT> information in accordance with applicable law, including federal and state securities laws
and regulations. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.15</B> <B><U>Acknowledgments</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Borrower and the other Credit Parties each hereby acknowledges that: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) it has been advised by counsel in the negotiation, execution and delivery of each Credit Document; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) neither the Administrative Agent nor any Lender has any fiduciary relationship with or duty to the Borrower or any other
Credit Party arising out of or in connection with this Agreement and the relationship between the Administrative Agent and the Lenders, on one hand, and the Borrower and the other Credit Parties, on the other hand, in connection herewith is solely
that of creditor and debtor; and </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) no joint venture exists among the Lenders and the Administrative Agent or among the
Borrower, the Administrative Agent or the other Credit Parties and the Lenders. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.16</B> <B><U>Waivers of
Jury Trial</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">EACH PARTY HERETO HEREBY IRREVOCABLY WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, ANY RIGHT IT MAY HAVE
TO A TRIAL BY JURY IN ANY LEGAL PROCEEDING DIRECTLY OR INDIRECTLY ARISING OUT OF OR RELATING TO THIS AGREEMENT OR ANY OTHER CREDIT DOCUMENT OR THE TRANSACTIONS CONTEMPLATED HEREBY OR THEREBY (WHETHER BASED ON CONTRACT, TORT OR ANY OTHER THEORY).
EACH PARTY HERETO (A)&nbsp;CERTIFIES THAT NO REPRESENTATIVE, AGENT OR ATTORNEY OF ANY OTHER PERSON HAS REPRESENTED, EXPRESSLY OR OTHERWISE, THAT SUCH OTHER PERSON WOULD NOT, IN THE EVENT OF LITIGATION, SEEK TO ENFORCE THE FOREGOING WAIVER AND
(B)&nbsp;ACKNOWLEDGES THAT IT AND THE OTHER PARTIES HERETO HAVE BEEN INDUCED TO ENTER INTO THIS AGREEMENT AND THE OTHER CREDIT DOCUMENTS BY, AMONG OTHER THINGS, THE MUTUAL WAIVERS AND CERTIFICATIONS IN THIS SECTION. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.17</B> <B><U>Patriot Act Notice</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each Lender and the Administrative Agent (for itself and not on behalf of any other party) hereby notifies the Borrower that, pursuant to the
requirements of the Patriot Act, it is required to obtain, verify and record information that identifies the Borrower and the other Credit Parties, which information includes the name and address of the Borrower and the other Credit Parties and
other information that will allow such Lender or the Administrative Agent, as applicable, to identify the Borrower and the other Credit Parties in accordance with the Patriot Act. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">96 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;9.18</B> <B><U>Resolution of Drafting Ambiguities</U></B>.
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each Credit Party acknowledges and agrees that it was represented by counsel in connection with the execution and delivery of this
Agreement and the other Credit Documents to which it is a party, that it and its counsel reviewed and participated in the preparation and negotiation hereof and thereof and that any rule of construction to the effect that ambiguities are to be
resolved against the drafting party shall not be employed in the interpretation hereof or thereof. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.19</B>
<B><U>Continuing Agreement</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">This Credit Agreement shall be a continuing agreement and shall remain in full force and effect until
all Credit Party Obligations (other than those obligations that expressly survive the termination of this Credit Agreement) have been paid in full and all Commitments and Letters of Credit have been terminated, after which this Credit Agreement
automatically shall terminate. Upon termination, the Credit Parties shall have no further obligations (other than those obligations that expressly survive the termination of this Credit Agreement) under the Credit Documents; <U>provided</U> that
should any payment, in whole or in part, of the Credit Party Obligations be rescinded or otherwise required to be restored or returned by the Administrative Agent or any Lender, whether as a result of any proceedings in bankruptcy or reorganization
or otherwise, then the Credit Documents shall automatically be reinstated and all Liens, if any, under the LOC Documents of the Administrative Agent shall reattach to the collateral and all amounts required to be restored or returned and all costs
and expenses incurred by the Administrative Agent or any Lender in connection therewith shall be deemed included as part of the Credit Party Obligations. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.20</B> <B><U>Lender Consent</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each Person signing a Lender Consent (a)&nbsp;approves the Credit Agreement, (b)&nbsp;authorizes and appoints the Administrative Agent as its
agent in accordance with the terms of <U>Article VIII</U>, (c)&nbsp;authorizes the Administrative Agent to execute and deliver this Agreement on its behalf, (d)&nbsp;is a Lender hereunder and therefore shall have all the rights and obligations of a
Lender under this Agreement as if such Person had directly executed and delivered a signature page to this Agreement and (e)&nbsp;has consented to, approved or accepted or is satisfied with, each document or other matter required under
Section&nbsp;4.1 to be consented to or approved by or be acceptable or satisfactory to a Lender. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.21</B>
<B><U>Press Releases and Related Matters</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Credit Parties and their Affiliates agree that they will not in the future issue any
press releases or other public disclosure using the name of Administrative Agent or any Lender or their respective Affiliates or referring to this Agreement or any of the Credit Documents without the prior written consent of such Person, unless (and
only to the extent that) a Credit Party or such Affiliate is required to do so under law and then, in any event, the Credit Parties or such Affiliate will to the extent practicable consult with such Person before issuing such press release or other
public disclosure, provided, that no consultation shall be required in connection with disclosures in a periodic or other report filed with or furnished to the SEC. The Credit Parties consent to the publication by Administrative Agent or any Lender
of customary advertising material relating to the transactions contemplated by this Agreement and the Credit Documents using the name, product photographs, logo or trademark of the Credit Parties. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.22</B> <B><U>Appointment of Borrower</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of the Guarantors hereby appoints the Borrower to act as its agent for all purposes under this Agreement and agrees that (a)&nbsp;the
Borrower may execute such documents on behalf of such Guarantor as the Borrower deems appropriate in its sole discretion and each Guarantor shall be obligated by all of the terms of any such document executed on its behalf, (b)&nbsp;any notice or
communication delivered by the Administrative Agent or the Lender to the Borrower shall be deemed delivered to each Guarantor and (c)&nbsp;the Administrative Agent or the Lenders may accept, and be permitted to rely on, any document, instrument or
agreement executed by the Borrower on behalf of each Guarantor. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">97 </P>

</DIV></Center>


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


<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"><B>Section</B><B></B><B>&nbsp;9.23</B> <B><U>Certain Waivers, Subordinations and
Consents</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Each of the Credit Parties acknowledges and agrees that certain Credit Parties and their Equity Holders are, or in
the future may be or become, subject to the terms of one or more Contractual Obligations with the Borrower or another Credit Party (including those arising under the terms of Management Agreements)&nbsp;(i) which conflict with the terms of the
Credit Documents to which such Credit Parties are a party, the execution and delivery thereof by such Credit Parties, or the performance by such Credit Parties of the terms thereof, including undertakings not to incur debt, not to pledge assets to
third parties, not to pay dividends and not to enter into material agreements without obtaining certain consents (collectively, the &#147;<U>Credit Party Intercompany Restrictions</U>&#148;), (ii) pursuant to which such Credit Parties grant to the
Borrower or such other Credit Party a Lien on various assets of such Credit Parties (collectively, the &#147;<U>Borrower Pledges</U>&#148;), (iii) pursuant to which Equity Holders grant to the Borrower or such other Credit Party the right, upon the
occurrence of certain circumstances, to acquire Equity Interests in such Credit Parties from the applicable Equity Holders (collectively, the &#147;<U>Holder Purchase Grants</U>&#148;), (iv) pursuant to which Equity Holders are restricted from
transferring their Equity Interests in a Practice (the &#147;<U>Equity Holder Transfer Restrictions</U>&#148;), and/or (v)&nbsp;pursuant to which Equity Holders grant to the Borrower or such other Credit Party a Lien on the Equity Interests in the
applicable Credit Parties owned by such Equity Holders (collectively, the &#147;<U>Holder Lien Grants</U>&#148;) (each agreement, including each Management Agreement, containing any such restriction being referred to herein as a &#147;<U>Restrictive
Agreement</U>&#148;). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Each of the Credit Parties hereby absolutely and irrevocably waives the Credit Party Intercompany Restrictions
and the Equity Holder Transfer Restrictions insofar as any of such Credit Party Intercompany Restrictions or Equity Holder Transfer Restrictions conflict with or would otherwise prohibit or impair the due, punctual and full performance and
observance of any term, covenant or condition now or hereafter contained in any Credit Document. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) The Borrower and each other Credit
Party party to any such Restrictive Agreement hereby agree that, except as expressly permitted hereunder or under the terms of any other Credit Document, no Credit Party shall exercise its rights under any of the Holder Purchase Grants. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) So long as no Default or Event of Default has occurred and is continuing: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) any Credit Party may at its expense exercise rights under Borrower Pledges and Holder Lien Grants as it may determine to be
reasonably necessary in the ordinary course of business (including the taking of possession of and selling or otherwise disposing of property subject to Borrower Pledges and Holder Lien Grants and retaining the proceeds thereof, in each case to the
extent permitted by applicable law) to recover amounts owed or otherwise remedy defaults in payment or performance obligations arising under Management Agreements; <U>provided</U>, that the Borrower shall set forth in the next officer&#146;s
certificate delivered to the Administrative Agent pursuant to Section&nbsp;5.2(b) for the period during which such rights are exercised a reasonably detailed description of the circumstances giving rise to such exercise and the remedies exercised;
and </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) the Borrower may at its expense exercise Holder Purchase Grants to the extent that such exercise would otherwise
be permitted hereunder as a Permitted Investment. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.24</B> <B><U>No Advisory or Fiduciary
Responsibility</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In connection with all aspects of each Transaction, each of the Credit Parties acknowledges and agrees, and
acknowledges its Affiliates&#146; understanding, that: (a)&nbsp;the credit facility provided for hereunder and any related arranging or other services in connection therewith (including in connection with any amendment, waiver or other modification
hereof or of any other Credit Document) are an <FONT STYLE="white-space:nowrap">arm&#146;s-length</FONT> commercial transaction between the Credit Parties and their Affiliates, on the one hand, and the Administrative Agent, the Arrangers and the
Lenders, on the other hand, and the Credit Parties are capable of evaluating and understanding and understand and accept the terms, risks and conditions of the Transactions and by the other Credit Documents (including any amendment, waiver or other
modification hereof or thereof); (b) in connection with the process leading to such transaction, each of the Administrative Agent, each Arranger and each Lender is and has been acting solely as a principal and is not the financial advisor, agent or
fiduciary, for any Credit Party or any of their Affiliates, stockholders, creditors or employees or any other Person; (c)&nbsp;neither the Administrative Agent nor any Arranger nor any Lender has assumed or will assume an advisory, agency or
fiduciary responsibility in favor of any Credit Party with respect to any of the Transactions or the process leading thereto, including with respect to any amendment, waiver or other modification hereof or of any other Credit Document (irrespective
of whether the Administrative Agent, any Arranger or any </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">98 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
Lender has advised or is currently advising any Credit Party or any of its Affiliates on other matters) and neither the Administrative Agent, nor any Arranger nor any Lender has any obligation to
any Credit Party or any of their Affiliates with respect to the Transactions except those obligations expressly set forth herein and in the other Credit Documents; (d)&nbsp;the Administrative Agent, the Arrangers, the Lenders and their respective
Affiliates may be engaged in a broad range of transactions that involve interests that differ from those of the Credit Parties and their Affiliates, and neither the Administrative Agent, nor any Arranger nor any Lender has any obligation to disclose
any of such interests by virtue of any advisory, agency or fiduciary relationship; and (e)&nbsp;the Administrative Agent, the Arrangers and the Lenders have not provided and will not provide any legal, accounting, regulatory or tax advice with
respect to any of the Transactions (including any amendment, waiver or other modification hereof or of any other Credit Document) and the Credit Parties have consulted their own legal, accounting, regulatory and tax advisors to the extent it has
deemed appropriate. Each of the Credit Parties hereby waives and releases, to the fullest extent permitted by law, any claims that it may have against the Administrative Agent, the Arrangers, the Lenders and their respective Affiliates with respect
to any breach or alleged breach of agency or fiduciary duty. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.25</B> <B><U>[Reserved]</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.26</B> <B><U>Release of Liens and Guarantees</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Administrative Agent shall (and each Lender hereby irrevocably authorizes the Administrative Agent to): </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) release any Lien granted to the Administrative Agent under any Credit Document on any asset of any Credit Party (i)&nbsp;upon payment in
full of the Credit Party Obligations and the cancellation of all Commitments hereunder, (ii)&nbsp;that is sold, transferred, encumbered or otherwise disposed of or to be sold, transferred, encumbered or otherwise disposed of as part of, or in
connection with, any sale, transfer or disposition permitted under the Credit Documents to a Person that is not (and is not required to become) a Credit Party, (iii)&nbsp;that does not constitute (or ceases to constitute) Collateral, (iv)&nbsp;if
such Credit Party has guaranteed the Obligations, upon the release of such Credit Party&#146;s guaranty in accordance with the terms of the Credit Documents, (v)&nbsp;that constitutes Excluded Assets, or (vi)&nbsp;to the extent such release is
approved, authorized or ratified in writing by the Required Lenders in accordance with <U>Section</U><U></U><U>&nbsp;9.1</U>; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b)
automatically release any Person that has guaranteed the Obligations from its guaranty if such Person ceases to be a Domestic Subsidiary as a result of a transaction or series of transactions that is permitted under the Credit Documents; and </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) subordinate any Lien granted to the Administrative Agent (or any <FONT STYLE="white-space:nowrap">sub-agent</FONT> or collateral agent)
under any Credit Document to any Lien that is permitted by clauses (c), (i) or (o)&nbsp;of the definition of Permitted Liens, or otherwise having priority by operation of law.</P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Administrative Agent will, and each Lender hereby authorizes the Administrative Agent to, at the expense of the Borrower, execute and
deliver to the relevant Credit Party such documents and/or instruments as such Credit Party may reasonably request to evidence or effectuate the release of any Lien or guarantee or the subordination of any Lien contemplated by this
<U>Section</U><U></U><U>&nbsp;9.26</U>; <U>provided</U>, that the Administrative Agent shall have received a certificate of a Responsible Officer of the Borrower containing certifications regarding compliance with the provisions of the Credit
Documents permitting the action giving rise to such action.&nbsp;Upon the request of the Administrative Agent, the Required Lenders will confirm in writing the Administrative Agent&#146;s authority to take the actions contemplated by this
<U>Section</U><U></U><U>&nbsp;9.26</U>.&nbsp;Any representation, warranty or covenant contained in any Credit Document relating to any asset of any Credit Party shall no longer be deemed to be made once the Lien on such asset is released in
accordance herewith. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.27</B> <B><U>Acknowledgement and Consent of
<FONT STYLE="white-space:nowrap">Bail-In</FONT> of EEA Financial Institutions</U></B>. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Solely to the extent any Agent, Lender or Issuing Lender that is an
EEA Financial Institution is a party to this Agreement and notwithstanding anything to the contrary in any Credit Document or in any other agreement, arrangement or understanding among any such parties, each party hereto acknowledges that any
liability of any Lender that is an EEA Financial Institution arising under any Credit Document, to the extent such liability is unsecured, may be subject to the write-down and conversion powers of an EEA Resolution Authority and agrees and consents
to, and acknowledges and agrees to be bound by: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) the application of any Write-Down and Conversion Powers by an EEA Resolution Authority
to any such liabilities arising hereunder which may be payable to it by any Lender that is an EEA Financial Institution; and </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">99 </P>

</DIV></Center>


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


<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">(b) the effects of any <FONT STYLE="white-space:nowrap">Bail-in</FONT> Action on any such
liability, including, if applicable: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) a reduction in full or in part or cancellation of any such liability; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) a conversion of all, or a portion of, such liability into shares or other instruments of ownership in such EEA Financial
Institution, its parent undertaking, or a bridge institution that may be issued to it or otherwise conferred on it, and that such shares or other instruments of ownership will be accepted by it in lieu of any rights with respect to any such
liability under this Agreement or any other Credit Document; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) the variation of the terms of such liability in
connection with the exercise of the write-down and conversion powers of any EEA Resolution Authority. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;9.28</B> <B><U>Certain ERISA Matters</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Each Lender (x)&nbsp;represents and warrants, as of the date such Person became a Lender party hereto, to, and (y)&nbsp;covenants, from the
date such Person became a Lender party hereto to the date such Person ceases being a Lender party hereto, for the benefit of, the Administrative Agent, the Arrangers,<STRIKE>the Joint Bookrunners and each Co-Documentation Agent</STRIKE> and their
respective Affiliates, and not, for the avoidance of doubt, to or for the benefit of the Borrower or any other Credit Party, that at least one of the following is and will be true: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) such Lender is not using &#147;plan assets&#148; (within the meaning of 29 CFR &#167;
<FONT STYLE="white-space:nowrap">2510.3-101,</FONT> as modified by Section&nbsp;3(42) of ERISA) of one or more Benefit Plans in connection with the Loans, the Letters of Credit or the Commitments, </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) the transaction exemption set forth in one or more PTEs, such as PTE <FONT STYLE="white-space:nowrap">84-14</FONT> (a
class exemption for certain transactions determined by independent qualified professional asset managers), PTE <FONT STYLE="white-space:nowrap">95-60</FONT> (a class exemption for certain transactions involving insurance company general accounts),
PTE <FONT STYLE="white-space:nowrap">90-1</FONT> (a class exemption for certain transactions involving insurance company pooled separate accounts), PTE <FONT STYLE="white-space:nowrap">91-38</FONT> (a class exemption for certain transactions
involving bank collective investment funds) or PTE <FONT STYLE="white-space:nowrap">96-23</FONT> (a class exemption for certain transactions determined by <FONT STYLE="white-space:nowrap">in-house</FONT> asset managers), is applicable with respect
to such Lender&#146;s entrance into, participation in, administration of and performance of the Loans, the Letters of Credit, the Commitments and this Agreement, </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) (A) such Lender is an investment fund managed by a &#147;Qualified Professional Asset Manager&#148; (within the meaning
of Part VI of PTE <FONT STYLE="white-space:nowrap">84-14),</FONT> (B) such Qualified Professional Asset Manager made the investment decision on behalf of such Lender to enter into, participate in, administer and perform the Loans, the Letters of
Credit, the Commitments and this Agreement, (C)&nbsp;the entrance into, participation in, administration of and performance of the Loans, the Letters of Credit, the Commitments and this Agreement satisfies the requirements of <FONT
STYLE="white-space:nowrap">sub-sections</FONT> (b)&nbsp;through (g) of Part I of PTE <FONT STYLE="white-space:nowrap">84-14</FONT> and (D)&nbsp;to the best knowledge of such Lender, the requirements of subsection (a)&nbsp;of&nbsp;Part I of PTE <FONT
STYLE="white-space:nowrap">84-14</FONT> are satisfied with respect to such Lender&#146;s entrance into, participation in, administration of and performance of the Loans, the Letters of Credit, the Commitments and this Agreement, or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iv) such other representation, warranty and covenant as may be agreed in writing between the Administrative Agent, in its sole
discretion, and such Lender. </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">100 </P>

</DIV></Center>


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


<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">(b) In addition, unless <FONT STYLE="white-space:nowrap">sub-clause</FONT> (i)&nbsp;in the
immediately preceding clause (a)&nbsp;is true with respect to a Lender or such Lender has not provided another representation, warranty and covenant as provided in <FONT STYLE="white-space:nowrap">sub-clause</FONT> (iv)&nbsp;in the immediately
preceding clause (a), such Lender further (x)&nbsp;represents and warrants, as of the date such Person became a Lender party hereto, to, and (y)&nbsp;covenants, from the date such Person became a Lender party hereto to the date such Person ceases
being a Lender party hereto, for the benefit of, the Administrative Agent, the Arrangers <STRIKE>, the Joint Bookrunners and the Co-Documentation Agents</STRIKE> and their respective Affiliates, and not, for the avoidance of doubt, to or for the
benefit of the Borrower or any other Credit Party, that<STRIKE>:</STRIKE> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>(i)</STRIKE> none of the Administrative
Agent, any Arranger , a<STRIKE>ny Joint Bookrunner or any Co-Documentation Agent</STRIKE> or any of their respective Affiliates is a fiduciary with respect to the <U STYLE="border-bottom:1pt double; padding-bottom:1pt">Collateral or the</U> assets
of such Lender (including in connection with the reservation or exercise of any rights by the Administrative Agent under this Agreement, any Credit Document or any documents related to hereto or
thereto)<STRIKE>,</STRIKE><U STYLE="border-bottom:1pt double; padding-bottom:1pt">.</U> </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>(ii) the Person making the
investment decision on behalf of such Lender with respect to</STRIKE> </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>the entrance into, participation in,
administration of and performance of the Loans, the Letters of Credit, the</STRIKE> </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>Commitments and this Agreement
is independent (within the meaning of 29 CFR &#167; 2510.3-21) and is a</STRIKE> </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>bank, an insurance carrier, an
investment adviser, a broker-dealer or other person that holds, or has under</STRIKE> </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>management or control, total
assets of at least $50 million, in each case as described in 29 CFR &#167; 2510.3-</STRIKE> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>21(c)(1)(i)(A)-(E),</STRIKE> </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(<STRIKE>iii) the Person making the investment decision on behalf of such Lender with respect</STRIKE> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>to the entrance into, participation in, administration of and performance of the Loans, the Letters of Credit,</STRIKE>
</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>the Commitments and this Agreement is capable of evaluating investment risks independently, both in</STRIKE> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>general and with regard to particular transactions and investment strategies (including in respect of the</STRIKE> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>Obligations),</STRIKE> </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>(iv) the Person making the investment decision on behalf of such Lender with respect</STRIKE> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>to the entrance into, participation in, administration of and performance of the Loans, the Letters of Credit,</STRIKE>
</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>the Commitments and this Agreement is a fiduciary under ERISA or the Code, or both, with respect to the</STRIKE>
</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>Loans, the Letters of Credit, the Commitments and this Agreement and is responsible for exercising</STRIKE> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>independent judgment in evaluating the transactions hereunder, and</STRIKE> </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>(v) no fee or other compensation is being paid directly to the Administrative Agent,</STRIKE> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>any Arranger or any their respective Affiliates for investment advice (as opposed to other services) in</STRIKE> </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"><STRIKE>connection with the Loans, the Letters of Credit, the Commitments or this Agreement</STRIKE><STRIKE>.</STRIKE> </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) The Administrative Agent, and each Arranger<U STYLE="border-bottom:1pt double; padding-bottom:1pt">, the syndication agent or other agents
listed on the cover page hereof</U> hereby informs the Lenders that each such Person is not undertaking to provide <STRIKE>impartial</STRIKE> investment advice, or to give advice in a fiduciary capacity, in connection with the transactions
contemplated hereby, and that such Person has a financial interest in the transactions contemplated hereby in that such Person or an Affiliate thereof (i)&nbsp;may receive interest or other payments with respect to the Loans, the Letters of Credit,
the Commitments <STRIKE>and</STRIKE>, this Agreement <U STYLE="border-bottom:1pt double; padding-bottom:1pt">and any other Credit Documents</U>, (ii)&nbsp;may recognize a gain if it extended the Loans, the Letters of Credit or the Commitments for an
amount less than the amount being paid for an interest in the Loans, the Letters of Credit or the Commitments by such Lender or (iii)&nbsp;may receive fees or other payments in connection with the transactions contemplated hereby, the Credit
Documents or otherwise, including structuring fees, commitment fees, arrangement fees, facility fees, upfront fees, underwriting fees, ticking fees, agency fees, administrative agent or collateral agent fees, utilization fees, minimum usage fees,
letter of credit fees, fronting fees, deal-away or alternate transaction fees, amendment fees, processing fees, term out premiums, banker&#146;s acceptance fees, breakage or other early termination fees or fees similar to the foregoing. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">101 </P>

</DIV></Center>


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


<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>ARTICLE X </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>GUARANTY </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;10.1</B> <B><U>The Guaranty</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In order to induce the Lenders to enter into this Agreement and any Bank Product Provider to enter into any Bank Product and to extend credit
hereunder and thereunder and in recognition of the direct benefits to be received by the Guarantors from the Extensions of Credit hereunder and any Bank Product, each of the Guarantors hereby agrees with the Administrative Agent, the Lenders and the
Bank Product Providers as follows: each Guarantor hereby unconditionally and irrevocably jointly and severally guarantees as primary obligor and not merely as surety the full and prompt payment when due, whether upon maturity, by acceleration or
otherwise, of any and all Credit Party Obligations. If any or all of the indebtedness or other obligations becomes due and payable hereunder or under any Bank Product, each Guarantor unconditionally promises to pay such indebtedness to the
Administrative Agent, the Lenders, the Bank Product Providers, or their respective order, on demand, together with any and all reasonable expenses which may be incurred by the Administrative Agent or the Lenders in collecting any of the Credit Party
Obligations. The Guaranty set forth in this <U>Article X</U> is a guaranty of timely payment and not of collection. The word &#147;indebtedness&#148; is used in this <U>Article X</U> in its most comprehensive sense and includes any and all advances,
debts, obligations and liabilities of the Borrower, including specifically all Credit Party Obligations, arising in connection with this Agreement, the other Credit Documents or any Bank Product, in each case, heretofore, now, or hereafter made,
incurred or created, whether voluntarily or involuntarily, absolute or contingent, liquidated or unliquidated, determined or undetermined, whether or not such indebtedness is from time to time reduced, or extinguished and thereafter increased or
incurred, whether the Borrower may be liable individually or jointly with others, whether or not recovery upon such indebtedness may be or hereafter become barred by any statute of limitations, and whether or not such indebtedness may be or
hereafter become otherwise unenforceable. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding any provision to the contrary contained herein or in any other of the Credit
Documents, to the extent the obligations of a Guarantor shall be adjudicated to be invalid or unenforceable for any reason (including, without limitation, because of any applicable state or federal law relating to fraudulent conveyances or
transfers) then the obligations of each such Guarantor hereunder shall be limited to the maximum amount that is permissible under applicable law (whether federal or state and including, without limitation, the Bankruptcy Code). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;10.2</B> <B><U>Bankruptcy</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Additionally, each of the Guarantors unconditionally and irrevocably guarantees jointly and severally the payment of any and all Credit Party
Obligations of the Borrower to the Lenders and any Bank Product Provider whether or not due or payable by the Borrower upon the occurrence of any Bankruptcy Event and unconditionally promises to pay such Credit Party Obligations to the
Administrative Agent for the account of the Lenders and to any such Bank Product Provider, or order, on demand, in lawful money of the United States. Each of the Guarantors further agrees that to the extent that the Borrower or a Guarantor shall
make a payment or a transfer of an interest in any property to the Administrative Agent, any Lender or any Bank Product Provider, which payment or transfer or any part thereof is subsequently invalidated, declared to be fraudulent or preferential,
or otherwise is avoided, and/or required to be repaid to the Borrower or a Guarantor, the estate of the Borrower or a Guarantor, a trustee, receiver or any other party under any bankruptcy law, state or federal law, common law or equitable cause,
then to the extent of such avoidance or repayment, the obligation or part thereof intended to be satisfied shall be revived and continued in full force and effect as if said payment had not been made. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;10.3</B> <B><U>Nature of Liability</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The liability of each Guarantor hereunder is exclusive and independent of any security for or other guaranty of the Credit Party Obligations of
the Borrower whether executed by any such Guarantor, any other guarantor or by any other party, and no Guarantor&#146;s liability hereunder shall be affected or impaired by (a)&nbsp;any direction as to application of payment by the Borrower or by
any other party, or (b)&nbsp;any other continuing or other guaranty, undertaking or maximum liability of a guarantor or of any other party as to the Credit Party Obligations of the Borrower, or (c)&nbsp;any payment on or in reduction of any such
other guaranty or undertaking, or (d)&nbsp;any dissolution, termination or increase, decrease or change in personnel by the Borrower, or (e)&nbsp;any payment made to the </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">102 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
Administrative Agent, the Lenders or any Bank Product Provider on the Credit Party Obligations which the Administrative Agent, such Lenders or such Bank Product Provider repay the Borrower
pursuant to court order in any bankruptcy, reorganization, arrangement, moratorium or other debtor relief proceeding, and each of the Guarantors waives any right to the deferral or modification of its obligations hereunder by reason of any such
proceeding. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;10.4</B> <B><U>Independent Obligation</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The obligations of each Guarantor hereunder are independent of the obligations of any other Guarantor or the Borrower, and a separate action or
actions may be brought and prosecuted against each Guarantor whether or not action is brought against any other Guarantor or the Borrower and whether or not any other Guarantor or the Borrower is joined in any such action or actions. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;10.5</B> <B><U>Authorization</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Each of the Guarantors authorizes the Administrative Agent, each Lender and each Bank Product Provider without notice or demand (except as
shall be required by applicable statute and cannot be waived), and without affecting or impairing its liability hereunder, from time to time to (a)&nbsp;renew, compromise, extend, increase, accelerate or otherwise change the time for payment of, or
otherwise change the terms of the Credit Party Obligations or any part thereof in accordance with this Agreement and any Bank product, as applicable, including any increase or decrease of the rate of interest thereon, (b)&nbsp;take and hold security
from any Guarantor or any other party for the payment of this Guaranty or the Credit Party Obligations and exchange, enforce waive and release any such security, (c)&nbsp;apply such security and direct the order or manner of sale thereof as the
Administrative Agent and the Lenders in their discretion may determine and (d)&nbsp;release or substitute any one or more endorsers, Guarantors, the Borrower or other obligors. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;10.6</B> <B><U>Reliance</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">It is not necessary for the Administrative Agent, the Lenders or any Bank Product Provider to inquire into the capacity or powers of the
Borrower or the officers, directors, members, partners or agents acting or purporting to act on its behalf, and any Credit Party Obligations made or created in reliance upon the professed exercise of such powers shall be guaranteed hereunder. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;10.7</B> <B><U>Waiver</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Each of the Guarantors waives any right (except as shall be required by applicable statute and cannot be waived) to require the
Administrative Agent, any Lender or any Bank Product Provider to (i)&nbsp;proceed against the Borrower, any other guarantor or any other party, (ii)&nbsp;proceed against or exhaust any security held from the Borrower, any other guarantor or any
other party, or (iii)&nbsp;pursue any other remedy in the Administrative Agent&#146;s, any Lender&#146;s or any Bank Product Provider&#146;s power whatsoever. Each of the Guarantors waives any defense based on or arising out of any defense of the
Borrower, any other guarantor or any other party other than payment in full of the Credit Party Obligations (other than contingent indemnification obligations), including, without limitation, any defense based on or arising out of the disability of
the Borrower, any other guarantor or any other party, or the unenforceability of the Credit Party Obligations or any part thereof from any cause, or the cessation from any cause of the liability of the Borrower other than payment in full of the
Credit Party Obligations. The Administrative Agent may, at its election, foreclose on any security held by the Administrative Agent or a Lender by one or more judicial or nonjudicial sales, whether or not every aspect of any such sale is
commercially reasonable (to the extent such sale is permitted by applicable law), or exercise any other right or remedy the Administrative Agent or any Lender may have against the Borrower or any other party, or any security, without affecting or
impairing in any way the liability of any Guarantor hereunder except to the extent the Credit Party Obligations have been paid in full and the Commitments have been terminated. Each of the Guarantors waives any defense arising out of any such
election by the Administrative Agent or any of the Lenders, even though such election operates to impair or extinguish any right of reimbursement or subrogation or other right or remedy of the Guarantors against the Borrower or any other party or
any security. </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">103 </P>

</DIV></Center>


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


<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">(b) Each of the Guarantors waives all presentments, demands for performance, protests and
notices, including, without limitation, notices of nonperformance, notice of protest, notices of dishonor, notices of acceptance of this Guaranty, and notices of the existence, creation or incurring of new or additional Credit Party Obligations.
Each Guarantor assumes all responsibility for being and keeping itself informed of the Borrower&#146;s financial condition and assets, and of all other circumstances bearing upon the risk of nonpayment of the Credit Party Obligations and the nature,
scope and extent of the risks which such Guarantor assumes and incurs hereunder, and agrees that neither the Administrative Agent nor any Lender shall have any duty to advise such Guarantor of information known to it regarding such circumstances or
risks. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) Each of the Guarantors hereby agrees it will not exercise any rights of subrogation which it may at any time otherwise have as
a result of this Guaranty (whether contractual, under Section&nbsp;509 of the U.S. Bankruptcy Code, or otherwise) to the claims of the Lenders or any Bank Product Provider against the Borrower or any other guarantor of the Credit Party Obligations
of the Borrower owing to the Lenders or such Bank Product Provider (collectively, the &#147;<U>Other Parties</U>&#148;) and all contractual, statutory or common law rights of reimbursement, contribution or indemnity from any Other Party which it may
at any time otherwise have as a result of this Guaranty until such time as the Credit Party Obligations shall have been paid in full and the Commitments have been terminated. Each of the Guarantors hereby further agrees not to exercise any right to
enforce any other remedy which the Administrative Agent, the Lenders or any Bank Product Provider now have or may hereafter have against any Other Party, any endorser or any other guarantor of all or any part of the Credit Party Obligations of the
Borrower and any benefit of, and any right to participate in, any security or collateral given to or for the benefit of the Lenders and/or the Bank Product Providers to secure payment of the Credit Party Obligations of the Borrower until such time
as the Credit Party Obligations (other than contingent indemnification obligations) shall have been paid in full and the Commitments have been terminated. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;10.8</B> <B><U>Limitation on Enforcement</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Lenders and the Bank Product Providers agree that this Guaranty may be enforced only by the action of the Administrative Agent acting upon
the instructions of the Required Lenders or such Bank Product Provider (only with respect to obligations under the applicable Bank Product) and that no Lender or Bank Product Provider shall have any right individually to seek to enforce or to
enforce this Guaranty, it being understood and agreed that such rights and remedies may be exercised by the Administrative Agent for the benefit of the Lenders under the terms of this Agreement and for the benefit of any Bank Product Provider under
any Bank Product. The Lenders and the Bank Product Providers further agree that this Guaranty may not be enforced against any director, officer, employee or stockholder of the Guarantors. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;10.9</B> <B><U>Confirmation of Payment</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Administrative Agent and the Lenders will, upon request after payment of the Credit Party Obligations which are the subject of this
Guaranty and termination of the Commitments relating thereto, confirm to the Borrower, the Guarantors or any other Person that such indebtedness and obligations have been paid and the Commitments relating thereto terminated, subject to the
provisions of Section&nbsp;10.2. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;10.10</B> <B><U>Agreements for Contribution</U></B>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) To the extent that any Guarantor is required, by reason of its obligations hereunder, to pay to the Lender an amount greater than the
amount of the value (as determined in accordance with applicable insolvency laws) actually made available to or for the benefit of such Guarantor on account of any Credit Document, such Guarantor shall have an enforceable right of contribution
against the remaining Guarantors, and the remaining Guarantors shall be jointly and severally liable for repayment of the full amount of such excess payment. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) To the extent that any Guarantor would, but for the operation of this Section&nbsp;10.10 and by reason of its Obligations hereunder or its
obligations to other Guarantors under this Section&nbsp;10.10, be rendered insolvent for any purpose under applicable insolvency laws, each of the Guarantors hereby agrees to indemnify such Guarantor and commits to make a contribution to such
Guarantor&#146;s capital in an amount at least equal to the amount necessary to prevent such Guarantor from having been rendered insolvent by reason of the incurrence of any such obligations. </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">104 </P>

</DIV></Center>


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


<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">(c) To the extent that any Guarantor would, but for the operation of this
Section&nbsp;10.10, be rendered insolvent under any applicable insolvency law by reason of its incurring of obligations to any other Guarantor under the foregoing Sections 10.10(a) and (b), such Guarantor shall, in turn, have rights of contribution
to the full extent provided in the foregoing Sections 10.10(a) and (b)&nbsp;against the remaining Guarantors, such that all obligations of all the Guarantors hereunder and under this Section&nbsp;10.10 shall be allocated in a manner such that no
Guarantor shall be rendered insolvent for any purpose under applicable insolvency law by reason of its incurrence of such obligations. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>Section</B><B></B><B>&nbsp;10.11</B> <B><U>Keepwell</U></B>. Each Qualified ECP Guarantor hereby jointly and severally absolutely,
unconditionally and irrevocably undertakes to provide such funds or other support as may be needed from time to time by each other Guarantor to honor all of its obligations under this Guaranty in respect of a Swap Obligation (provided, however, that
each Qualified ECP Guarantor shall only be liable under this Section&nbsp;10.11 for the maximum amount of such liability that can be hereby incurred without rendering its obligations under this Section&nbsp;10.11 or otherwise under this Guaranty
voidable under applicable law relating to fraudulent conveyance or fraudulent transfer, and not for any greater amount). Except as otherwise provided herein, the obligations of each Qualified ECP Guarantor under this Section&nbsp;10.11 shall remain
in full force and effect until the termination of all Swap Obligations. Each Qualified ECP Guarantor intends that this Section&nbsp;10.11 constitute, and this Section&nbsp;10.11 shall be deemed to constitute, a &#147;keepwell, support, or other
agreement&#148; for the benefit of each other Credit Party for all purposes of Section&nbsp;1a(18)(A)(v)(II) of the Commodity Exchange Act. </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">105 </P>

</DIV></Center>

</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-10.35
<SEQUENCE>4
<FILENAME>d671465dex1035.htm
<DESCRIPTION>EX-10.35
<TEXT>
<HTML><HEAD>
<TITLE>EX-10.35</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 10.35 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>EMPLOYMENT AGREEMENT </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>THIS EMPLOYMENT AGREEMENT</B> (this &#147;Agreement&#148;) is made and entered into by and between <B>MEDNAX SERVICES, INC.</B>, a Florida
corporation (&#147;Employer&#148;) and <B>DOMINIC J. ANDREANO</B> (&#147;Employee&#148;) effective as the Effective Date. </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>RECITALS
</B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>WHEREAS</B>,<B> </B>Employer is presently engaged in &#147;Employer&#146;s Business&#148; as defined on Exhibit A hereto; and </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>WHEREAS</B>, Employer desires to continue to employ Employee and benefit from Employee&#146;s contributions to Employer; and </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>WHEREAS</B>, Employer and Employee previously entered in an Employment Agreement dated February&nbsp;12, 2018<B> </B>(the &#147;Prior
Employment Agreement&#148;), which will be superseded in its entirety upon the execution of this Agreement; and </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>WHEREAS</B>, in order
to induce Employer to enter into this Agreement on the terms and conditions set forth herein, and disclose its trade secrets and confidential information in connection with Employee&#146;s employment by Employer and award from time to time equity
based compensation, Employee hereby agrees to be bound by the terms of this Agreement, including the arbitration, <FONT STYLE="white-space:nowrap">non-competition</FONT> and related restrictive covenants set forth herein. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>NOW, THEREFORE</B>, in consideration of the premises and mutual covenants set forth herein, the parties agree as follows: </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>1. Employment. </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">1.1.
<I>Employment and Term</I>. Employer hereby agrees to employ Employee and Employee hereby agrees to serve Employer on the terms and conditions set forth herein for an &#147;Initial Term&#148; commencing February&nbsp;12, 2019<B> </B>(the
&#147;Effective Date&#148;) and continuing for a period of three (3)&nbsp;years, unless sooner terminated as hereinafter set forth. Thereafter, the employment of Employee hereunder shall automatically renew for successive one (1)&nbsp;year periods
until terminated in accordance herewith. The Initial Term and any automatic renewals shall be referred to as the &#147;Employment Period.&#148; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">1.2. <I>Duties of Employee</I>. During the Employment Period, Employee shall serve as Senior Vice President, General Counsel and Secretary of
Employer and MEDNAX, Inc. and perform such duties as are customary to the position Employee holds or as may be assigned to Employee from time to time by Employee&#146;s supervisor (&#147;Employee&#146;s Supervisor&#148;); <I>provided, </I>that such
duties as assigned shall be customary to Employee&#146;s role as an officer of Employer. Employee&#146;s employment shall be full-time and as such Employee agrees to devote substantially all of Employee&#146;s attention and professional time to the
business and affairs of Employer. Employee shall perform Employee&#146;s duties honestly, diligently, competently, in good faith and in </P>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
the best interest of Employer. Employee will devote best efforts to the promotion of the goodwill of Employer and of its employees and affiliates. During the Employment Term, Employer shall
promote the proficiency of Employee by, among other things, providing Employee with Confidential Information, specialized professional development programs, and information regarding the organization, administration and operation of Employer. During
the Employment Period, Employee agrees that Employee will not, without the prior written consent of Employer (which consent shall not be unreasonably withheld), serve as a director on a corporate board of directors or in any other similar capacity
for any institution other than Employer. During the Employment Period, it shall not be a violation of this Agreement to (i)&nbsp;serve on civic or charitable boards or committees, or (ii)&nbsp;deliver lectures, fulfill speaking engagements or teach
at educational institutions, so long as such activities have been approved by Employee&#146;s Supervisor and do not interfere with the performance of Employee&#146;s responsibilities as an employee of Employer in accordance with this Agreement,
including the restrictions of Section&nbsp;8 hereof. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">1.3. <I>Place of Performance</I>. Employee shall be based at Employer&#146;s offices
located in Sunrise, Florida, except for required travel relating to Employer&#146;s Business. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>2. Base Salary and Performance Bonus.
</B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">2.1. <I>Base Salary</I>. Employee shall be paid an annual base salary as determined by Employee&#146;s supervisor from time to time
(the &#147;Base Salary&#148;), payable in installments consistent with Employer&#146;s customary payroll schedule and subject to applicable withholding for taxes and other Employee directed withholdings. Any increase to Employee&#146;s Base Salary
that is approved by Employee&#146;s Supervisor shall become Employee&#146;s new Base Salary for purposes of this Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">2.2.
<I>Performance Bonus</I>. Employee shall be eligible for an annual bonus of up to the amount set forth on Exhibit B (the &#147;Performance Bonus&#148;). The amount of the actual bonus paid to Employee, if any, shall be based upon the achievement of
specific objectives to be developed and agreed upon by Employee and Employee&#146;s Supervisor each year and the performance of Employer. Except in the situations described in Sections 5.2, 5.3, 5.4, 5.5 and 5.7, the Performance Bonus shall only be
payable to Employee if Employee is employed with Employer as of the date that the Performance Bonus is paid by Employer. Each Performance Bonus shall be paid in the calendar year immediately following the calendar year in which it is earned, as soon
as practicable after the audited financial statements for Employer for the year for which the bonus is earned have been released; provided, however, that if calculation of Employee&#146;s Performance Bonus is not administratively practicable due to
events beyond the control of Employer, then Employer may delay payment of the Performance Bonus provided that the payment is made during the first taxable year of Employee in which the calculation of the amount of the payment is administratively
practicable. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>3. Benefits. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">3.1. <I>Expense Reimbursement</I>. Employer shall promptly reimburse Employee for all <FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> expenses reasonably incurred by Employee during the Employment Period on behalf of or in connection with Employer&#146;s Business pursuant to the reimbursement standards and guidelines of
Employer in effect from time to time. Employee shall account for such expenses and submit reasonable supporting documentation to Employer in accordance with Employer&#146;s policies in effect from time to time. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">2 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">3.2 <I>Employee Benefits</I>. During the Employment Period, Employee shall be entitled to
participate in such health, welfare, disability, retirement savings and other fringe benefit plans and programs (subject to the terms and conditions of such plans and programs) as may be provided from time to time to employees of Employer and to the
extent that such plans and programs are applicable to other similarly situated employees of Employer. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">3.3. <I>Leave Time</I>. During the
Employment Period, Employee shall be entitled to paid vacation and leave days each calendar year in accordance with the leave policies established by Employer from time to time, but in no event less than thirty-eight (38)&nbsp;days per year. Any
leave time not used during each fiscal year of Employer may be carried over into the next year to the extent permitted by Employer policy. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">3.4 <I>Equity Plans. </I>During the Employment Period, Employee shall be eligible to participate in MEDNAX, Inc.&#145;s Amended and Restated
2008 Incentive Compensation Plan, as amended, or any other similar plan adopted by MEDNAX, Inc. (each an &#147;Equity Plan&#148;) that provides for the issuance of stock options, stock appreciation rights, restricted stock, deferred stock, bonus
stock, awards payable in stock or any other stock based award (each an &#147;Equity Award&#148;). Employee&#146;s stock-based award each year shall be determined by the Compensation Committee of MEDNAX, Inc.&#146;s Board of Directors based on
Employee&#146;s performance and Employer&#146;s performance during the immediately preceding year and shall be at least the amount set forth on Exhibit B hereto. Every Equity Award made to Employee shall be subject to the terms and conditions of
this Agreement, the applicable award agreement and the terms of the Equity Plan. Employee shall also be eligible to participate in MEDNAX, Inc.&#146;s <FONT STYLE="white-space:nowrap">non-qualified</FONT> employee stock purchase plan and any
successor plan. Employee acknowledges Employee&#146;s participation in the Equity Plan pursuant to this Section&nbsp;3 is sufficient consideration for Employee to enter into this Agreement, including the restrictive covenants set forth in
Section&nbsp;8 below<I>. </I> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>4. Termination. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.1. <I>Termination for Cause</I>. Employer may terminate Employee&#146;s employment under this Agreement for Cause. As used in this
Agreement, the term &#147;Cause&#148; shall mean: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) Any act or omission of Employee, which is materially contrary
(having reference to corporate and industry custom and standards) to the business interests, reputation or goodwill of Employer; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) A material breach by Employee of Employee&#146;s obligations under this Agreement, which breach is not promptly remedied
upon written notice from Employer; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) Employee&#146;s refusal to perform Employee&#146;s duties as assigned pursuant to
this Agreement other than a refusal which is remedied by Employee promptly after receipt of written notice thereof by Employer; or </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">


<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">(d) Employee&#146;s failure or refusal to comply with a reasonable policy,
standard or regulation of Employer in any material respect, including but not limited to Employer&#146;s sexual harassment, other unlawful harassment, workplace discrimination or substance abuse policies. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">The termination date for a termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.1 shall be the date specified by
Employer in a written notice to Employee of finding of Cause, which may not be retroactive. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.1, Employee shall be entitled to the compensation
specified in Section&nbsp;5.1 hereof. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.2. <I>Disability</I>. Employer may terminate Employee&#146;s employment under this Agreement upon
the Disability (as defined below) of Employee. Subject to the requirements of applicable law, Employee shall be deemed to have a &#147;Disability&#148; for purposes of this Agreement in the event of (i)&nbsp;Employee&#146;s inability to perform
Employee&#146;s duties hereunder, with or without a reasonable accommodation, as a result of physical or mental illness or injury, and (ii)&nbsp;a determination by an independent qualified physician selected by Employer and acceptable to Employee
(which acceptance shall not be unreasonably withheld) that Employee is currently unable to perform such duties and in all reasonable likelihood such inability will continue for a period in excess of an additional ninety (90)&nbsp;or more days in any
one hundred twenty (120)&nbsp;day period. The termination date for a termination of this Agreement pursuant to this Section&nbsp;4.2 shall be the date specified by Employer in a notice to Employee, which date shall not be retroactive. Upon any
termination of this Agreement pursuant to this Section&nbsp;4.2, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.2 hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.3. <I>Death</I>. Employee&#146;s employment under this Agreement shall terminate automatically upon the death of Employee, without any
requirement of notice by Employer to Employee&#146;s estate. The date of Employee&#146;s death shall be the termination date for a termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.3. Upon any termination
of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.3, Employee shall be entitled to the compensation specified in Section&nbsp;5.3 hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.4. <I>Termination by Employer Without Cause</I>. Employer may terminate Employee&#146;s employment without cause by giving Employee written
notice of such termination. The termination date shall be the date specified by Employer in such notice, which may be up to ninety (90)&nbsp;days from the date of such notice. Upon any termination of Employee&#146;s employment under this Agreement
pursuant to this Section&nbsp;4.4, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.4 hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.5. <I>Termination by Employee Due to Poor Health</I>. Employee may terminate Employee&#146;s employment under this Agreement upon written
notice to Employer if Employee&#146;s health should become impaired to any extent that makes the continued performance of Employee&#146;s duties under this Agreement hazardous to Employee&#146;s physical or mental health or Employee&#146;s life
(regardless of whether such condition would be deemed a Disability under any other Section of </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
this Agreement), <I>provided </I>that Employee shall have furnished Employer with a written statement from a qualified doctor to that effect, and <I>provided further</I> that, at Employer&#146;s
written request and expense, Employee shall submit to a medical examination by an independent qualified physician selected by Employer and acceptable to Employee (which acceptance shall not be unreasonably withheld), which doctor shall substantially
concur with the conclusions of Employee&#146;s doctor. The termination date shall be the date specified in Employee&#146;s notice to Employer, which date may not be earlier than thirty (30)&nbsp;days nor later than ninety (90)&nbsp;days from
Employer&#146;s receipt of such notice. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.5, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the
provisions of Section&nbsp;5.5 hereof. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.6. <I>Termination by Employee</I>. Employee may terminate Employee&#146;s employment under this
Agreement for any reason whatsoever upon not less than ninety (90)&nbsp;days prior written notice to Employer. Upon receipt of such notice from Employee, Employer may, at its option, require Employee to terminate employment at any time in advance of
the expiration of such ninety (90)&nbsp;day period. The termination date under this Section&nbsp;4.6 shall be the date specified by Employer, but in no event more than ninety (90)&nbsp;days after Employer&#146;s receipt of notice from Employee as
contemplated by this Section. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.6, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of
Section&nbsp;5.6 hereof. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.7. <I>Termination by Employee for Good Reason. </I>Employee may terminate Employee&#146;s employment hereunder
for Good Reason. For purposes of this Section, &#147;Good Reason&#148; shall mean: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) a decrease in Employee&#146;s Base
Salary; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) a decrease in the Performance Bonus potential utilized by Employer in determining a Performance Bonus for
Employee or a failure of the Compensation Committee to approve Employee&#146;s annual equity grant as contemplated by Section&nbsp;3.4; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) within a twenty-four (24)&nbsp;month period after a Change in Control (as defined below), Employee is either
(i)&nbsp;terminated pursuant to Section&nbsp;4.4 or Employee terminates Employee&#146;s employment pursuant to Section&nbsp;4.7 (a),(b),(d),(e) or (f), (ii) assigned any position, duties, responsibilities or compensation that is inconsistent with
the position, duties, responsibilities or compensation of Employee prior to such Change in Control, (iii)&nbsp;required to report to any person other than the President or Chief Executive Officer of Employer in place just prior to the Change in
Control (unless Employee becomes Chief Executive Officer of Employer or its equivalent and reports directly to the Board, as defined below), or (iv)&nbsp;required to perform services under this Agreement from another location more than twenty-five
(25)&nbsp;miles from Employee&#146;s location prior to the Change in Control. For purposes of this Agreement, &#147;Change in Control&#148; shall mean (i)&nbsp;the acquisition by a person or an entity or a group of persons and entities, directly or
indirectly, of more than fifty (50%) percent of MEDNAX, Inc.&#146;s common stock in a single transaction or a series of transactions (hereinafter referred to as a &#147;50% Change in Control&#148;), (ii) a merger or other form of corporate
reorganization of MEDNAX, Inc. resulting in an actual </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
or <I>de facto</I> 50% Change in Control, or (iii)&nbsp;the failure of Applicable Directors (defined below) to constitute a majority of MEDNAX, Inc.&#146;s Board of Directors (the
&#147;Board&#148;) during any two (2)&nbsp;consecutive year period after the date of this Agreement (the <FONT STYLE="white-space:nowrap">&#147;Two-Year</FONT> Period&#148;). &#147;Applicable Directors&#148; shall mean those individuals who are
members of the Board at the inception of a <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period and any new director whose election to the Board or nomination for election to the Board was approved (prior to any vote thereon by the shareholders)
by a vote of at least <FONT STYLE="white-space:nowrap">two-thirds</FONT> (2/3) of the directors then still in office who either were directors at the beginning of the <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period at issue or whose election
or nomination for election during such <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period was previously approved as provided in this sentence; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) the assignment to Employee of any position inconsistent with the present position Employee holds, or material diminution in
Employee&#146;s authority, excluding for this purpose any isolated, insubstantial and inadvertent action not taken in bad faith and which is remedied by Employer promptly after receipt of written notice; or </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) the requirement by Employer that Employee be based in any office or location outside of the metropolitan area where
Employer&#146;s present corporate offices are located (it being understood that Employee may be presently based at another location), except for travel reasonably required in the performance of Employee&#146;s duties. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) any other action or inaction that constitutes a material breach of this Agreement by Employer. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">If Employee desires to terminate Employee&#146;s employment under this Agreement pursuant to this Section, Employee must, within one hundred eighty
(180)&nbsp;days after the occurrence of events giving rise to the Good Reason, provide Employer with a written notice describing the Good Reason in reasonable detail. If Employer fails to cure the matter cited within thirty (30)&nbsp;days after the
date of Employee&#146;s notice, then this Agreement shall terminate as of the end of such thirty (30)&nbsp;day cure period, <I>provided, however, </I>that Employer may, at its option, require Employee to terminate employment at any time in advance
of the expiration of such thirty (30)&nbsp;day cure period. If Employee terminates Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.7, then Employee shall be entitled to compensation and/or benefits in accordance with,
and subject to, the provisions of Section&nbsp;5.7 hereof. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>5. Compensation and Benefits Upon Termination. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.1. <I>Cause</I>. If Employee&#146;s employment is terminated for Cause, Employer shall pay Employee&#146;s Base Salary through the
termination date specified in Section&nbsp;4.1 at the rate in effect at the termination date. Upon payment of such amounts, plus any amounts as may be due under Section&nbsp;5.8 below, Employer shall have no further obligation to Employee under this
Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.2. <I>Disability</I>. In the event of Employee&#146;s Disability, Employee shall continue to receive Employee&#146;s Base
Salary for the first ninety (90)&nbsp;days of Disability. If Employee&#146;s employment is terminated pursuant to Section&nbsp;4.2 in connection with Employee&#146;s Disability, Employee shall receive Employee&#146;s monthly Base Salary for a period
of twelve (12)&nbsp;months after the termination date, plus a bonus calculated in accordance with Section&nbsp;5.11 and any amounts as may be due under Section&nbsp;5.8, 5.9 and 5.14. </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.3. <I>Death</I>. Upon Employee&#146;s death during the Employment Period, Employer shall
pay to the person or entity designated by Employee in a notice filed with Employer or, if no person is designated, to Employee&#146;s estate any unpaid amounts of Base Salary to the date of Employee&#146;s death, plus any amounts as may be due under
Sections 5.8 and 5.11 and 5.14 below. Any payments Employee&#146;s spouse, beneficiaries or estate may be entitled to receive pursuant to any pension plan, employee welfare benefit plan, life insurance policy, or similar plan or policy then
maintained by Employer shall be determined and paid in accordance with the written instruments governing the respective plans and policies. In the event of Employee&#146;s death during the Employment Period, Employer shall notify Employee&#146;s
designee or estate of the Equity Awards held by Employee and the procedures pursuant to which all vested stock options may be exercised and other Equity Awards may be realized under the terms applicable to such awards. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.4. <I>Termination by Employer Without Cause</I>. If Employer terminates Employee&#146;s employment in accordance with Section&nbsp;4.4, then
(i)&nbsp;Employer shall pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.4 at the rate in effect at such termination date, plus any amount due under Section&nbsp;5.8 hereof; (ii)&nbsp;within thirty
(30)&nbsp;days, pay Employee a bonus calculated in accordance with Section&nbsp;5.11 hereof; (iii)&nbsp;Employer shall continue to pay Employee&#146;s monthly Base Salary for a period of eighteen (18)&nbsp;months after the termination date;
(iv)&nbsp;within thirty (30)&nbsp;days of the first (1<SUP STYLE="font-size:85%; vertical-align:top">st</SUP>)&nbsp;anniversary of the termination date, pay Employee an amount equal to the greater of Employee&#146;s Average Annual Performance Bonus
(as defined below) or Employee&#146;s bonus for the year immediately preceding Employee&#146;s termination; and (v)&nbsp;if applicable, Employee shall vest into the Accelerated Awards (as defined below) as set forth in Section&nbsp;5.14 hereof. For
purposes of this Agreement, &#147;Average Annual Performance Bonus&#148; shall be equal to the average of the percentage of the Performance Bonus target achieved by Employee for the three (3)&nbsp;full calendar years prior to the termination date,
and calculated based on Employee&#146;s Base Salary and target Performance Bonus in Employee&#146;s current position. <I>For illustration purposes, if Employee earned 40%, 100% and 70% of Employee&#146;s target Performance Bonus in each of the three
full calendar years prior to termination, and Employee&#146;s current target Performance Bonus was 100% of Base Salary, and Base Salary was $450,000.00, then Employee&#146;s Average Annual Performance Bonus would equal $315,000.00. ((40%+ 100% +
70%) / 3 x 100% x $450,000.00 = $315,000.00). </I> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.5. <I>Termination by Employee Due to Poor Health. </I>If Employee terminates
Employee&#146;s employment under this Agreement pursuant to Section&nbsp;4.5 hereof, Employer shall pay to Employee any unpaid amounts of Base Salary to the termination date specified in Section&nbsp;4.5, plus any disability payments otherwise
payable by or pursuant to plans provided by Employer, plus any amounts as may be due under Sections 5.8, 5.11 and 5.14 below. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.6.
<I>Termination by Employee</I>. If Employee&#146;s employment under this Agreement terminates pursuant to Section&nbsp;4.6 hereof, Employer shall pay to Employee any unpaid amounts of Base Salary to the termination date specified in
Section&nbsp;4.6, plus any amounts as may be due under Section&nbsp;5.8 below. In the event that the termination date specified by Employer is less than ninety (90)&nbsp;days after the date of Employer&#146;s receipt of notice as contemplated by
Section&nbsp;4.6, then Employer shall continue Employee&#146;s Base Salary for a period of days equal to ninety (90)&nbsp;minus the number of days from Employee&#146;s notice to the termination date. </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.7. <I>Termination for Good Reason.</I><B> </B>If Employee&#146;s employment under this
Agreement is terminated pursuant to Sections&nbsp;4.7(a), (b), (d), (e), or (f), then Employer shall (i)&nbsp;pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.7 at the rate in effect at such termination date,
(ii)&nbsp;pay any amounts as may be due under Section&nbsp;5.8 and 5.11, (iii) continue to pay Employee&#146;s Base Salary for a period of eighteen (18)&nbsp;months after the termination date, and (iv)&nbsp;if applicable, Employee shall vest into
the Accelerated Awards (as defined below) as set forth in Section&nbsp;5.14 hereof. If this Agreement is terminated pursuant to Section&nbsp;4.7(c), then Employer shall (i)&nbsp;pay Employee&#146;s Base Salary through the termination date specified
in Section&nbsp;4.7 at the rate in effect at such termination date, (ii)&nbsp;pay any amounts as may be due under Sections 5.8 and 5.11, and (iii)&nbsp;continue to pay Employee&#146;s Base Salary for a period of twenty-four (24)&nbsp;months after
the termination date. <B></B>In addition, notwithstanding any contrary provision in any Equity Plan, in the event of Employee&#146;s termination pursuant to Section&nbsp;4.7(c), any unvested Equity Awards held by Employee on the termination date
shall fully vest and in the case of stock options, become immediately exercisable. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.8. <I>Expense Reimbursement. </I>Employee shall be
entitled to reimbursement for reasonable business expenses incurred prior to the termination date, subject, however to the provisions of Section&nbsp;3.1. Such reimbursement shall be made at the times and in accordance with Employer&#146;s normal
procedures for reimbursements. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.9. <I>Continuation of Benefit Plans</I>. Employee shall be entitled to continuation of health, medical,
hospitalization and other similar health insurance programs on the same basis as regular, full-time employees of Employer and their eligible dependents during the period that Employee is receiving Base Salary payments under Section&nbsp;5 of this
Agreement and, in all cases, as provided by any applicable law. Following such period of continued benefit plan coverage, Employee and each of his eligible dependents shall be entitled to elect for continuation of coverage provided pursuant to
Section&nbsp;601 et. seq. of the Employee Retirement Income Security Act of 1974, 29 USC &#167;1101 (&#147;COBRA&#148;). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.10 <I>Period
for Exercising Stock Options After Termination. </I>Except as to incentive stock options granted in accordance with Section&nbsp;422 of the Internal Revenue Code, after termination of Employee&#146;s employment under this Agreement for any reason
other than pursuant to Section&nbsp;4.1, Employee shall be allowed a period of twelve months during which to exercise any vested options to purchase MEDNAX, Inc.&#146;s common stock or vested stock appreciation rights and realize any other vested
Equity Awards that may be granted or made under any Equity Plan; provided, however, that in no event shall the period during which Employee may exercise any vested stock option or vested stock appreciation right be extended pursuant to this
Section&nbsp;5.10 to a date that is later than the earlier of (i)&nbsp;the latest date upon which the stock right could have expired by its original terms under any circumstances or (ii)&nbsp;the tenth (10<SUP
STYLE="font-size:85%; vertical-align:top">th</SUP>) anniversary of the original date of grant of the stock right. In all other respects, the terms of the applicable Equity Plan shall control the terms and conditions of any Equity Awards. </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">8 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.11. <I>Performance Bonus. </I>In the situations described in Sections 5.2, 5.3, 5.4, 5.5
and 5.7, upon termination of this Agreement, Employee<B> </B>will be paid, solely in consideration of services rendered by Employee prior to termination, a bonus with respect to Employer&#146;s fiscal year in which the termination date occurs, equal
to the Performance Bonus, if any, that would have been payable to Employee, based on Employee and Employer meeting certain goals and objectives, for the fiscal year if Employee&#146;s employment had not been terminated, multiplied by the number of
days in the fiscal year prior to and including the date of termination and divided by three hundred sixty five (365). The amount of the Post-Termination Performance Bonus paid in the situations described in Sections 5.2, 5.3, 5.4 5.5 and 5.7 shall
be determined in good faith by Employer in its sole discretion at the time that Employer distributes bonuses to similarly situated employees. Any amount payable under this Section&nbsp;5.11 shall be paid to Employee when Employer pays performance
bonuses to its eligible employees, which shall be in the calendar year following the termination date of this Agreement. In addition, in the situations described in Section&nbsp;5.7, Employee will be paid, solely in consideration of services
rendered by Employee prior to termination, an additional bonus with respect to Employer&#146;s fiscal year in which the termination date occurs, equal to the greater of Employee&#146;s Average Annual Performance Bonus (as defined in
Section&nbsp;5.4) or Employee&#146;s bonus for the year immediately preceding Employee&#146;s termination. Such additional bonus shall be payable to Employee within ninety (90)&nbsp;days of Employee&#146;s termination date pursuant to
Section&nbsp;4.7. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.12. <I>Section</I> <I>409A Compliance</I>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) General.<B> </B>It is the intention of both Employer and Employee that the benefits and rights to which Employee could be
entitled in connection with termination of employment comply with Section&nbsp;409A of the Code and the Treasury Regulations and other guidance promulgated or issued thereunder (&#147;Section&nbsp;409A&#148;), and the provisions of this Agreement
shall be construed in a manner consistent with that intention. If Employee or Employer believes, at any time, that any such benefit or right does not so comply, it shall promptly advise the other and shall negotiate reasonably and in good faith to
amend the terms of such benefits and rights such that they comply with Section&nbsp;409A of the Code (with the most limited possible economic effect on Employee and on Employer). </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Distributions on Account of Separation from Service.<B> </B>If and to the extent required to comply with Section&nbsp;409A,
no payment or benefit required to be paid under this Agreement on account of termination of Employee&#146;s employment shall be made unless and until Employee incurs a &#147;separation from service&#148;, within the meaning of Section&nbsp;409A.
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) 6 Month Delay for Specified Employees. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) If Employee is a &#147;specified employee&#148;, then no payment or benefit that is payable on account of Employee&#146;s
&#147;separation from service&#148;, as that term is defined for purposes of Section&nbsp;409A, shall be made before the date that is six months after Employee&#146;s &#147;separation from service&#148; (or, if earlier, the date of Employee&#146;s
death) if and to the extent that such payment or benefit constitutes deferred compensation (or may be nonqualified deferred compensation) under Section&nbsp;409A and such deferral is required to comply with the requirements of Section&nbsp;409A. Any
payment or benefit delayed by reason of the prior sentence shall be paid out or provided in a single lump sum at the end of such required delay period in order to catch up to the original payment schedule. </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) For purposes of this provision, Employee shall be considered to be a
&#147;specified employee&#148; if, at the time of his or her separation from service, Employee is a &#147;key employee&#148;, within the meaning of Section&nbsp;416(i) of the Code, of Employer (or any person or entity with whom Employer would be
considered a single employer under Section&nbsp;414(b) or Section&nbsp;414(c) of the Code) any stock in which is publicly traded on an established securities market or otherwise. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) Unless otherwise required to comply with Section&nbsp;409A, a payment or benefit shall not be deferred pursuant to this
provision if: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:13%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(x) it is not made on account of Employee&#146;s &#147;separation from service&#148;, (y) it is required to
be paid no later than within 2 <SUP STYLE="vertical-align:top">1</SUP>&#8260;<SUB STYLE="vertical-align:bottom">2</SUB> months after the end of the taxable year of Employee in which the payment or benefit is no longer subject to a &#147;substantial
risk of forfeiture&#148;, as that term is defined for purposes of Section&nbsp;409A, or (z)&nbsp;the payment satisfies the following requirements: (A)&nbsp;it is being paid or provided due to Employer&#146;s termination of Employee&#146;s employment
without Cause (Section 4.4) or Employee&#146;s termination of employment after a Change in Control for the reasons set forth in Section&nbsp;4.7 hereof, (B)&nbsp;it does not exceed two times the lesser of (1)&nbsp;Employee&#146;s annualized
compensation from Employer for the calendar year prior to the calendar year in which the termination of Employee&#146;s employment occurs, and (2)&nbsp;the maximum amount of compensation that may be taken into account under a qualified plan pursuant
to Section&nbsp;401(a)(17) of the Code for the year in which Employee&#146;s employment terminates, and (C)&nbsp;the payment is required under this Agreement to be paid no later than the last day of the second calendar year following the calendar
year in which Employee incurs a &#147;separation from service&#148;. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) No Acceleration of Payments. Neither Employer nor
Employee, individually or in combination, may accelerate any payment or benefit that is subject to Section&nbsp;409A, except in compliance with Section&nbsp;409A and the provisions of this Agreement, and no amount shall be paid prior to the earliest
date on which it may be paid without violating Section&nbsp;409A. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) Treatment of Each Installment as a Separate Payment.
For purposes of applying the provisions of Section&nbsp;409A to this Agreement, each separately identified amount to which Employee is entitled under this Agreement shall be treated as a separate payment. In addition, to the extent permissible under
Section&nbsp;409A, any series of installment payments under this Agreement shall be treated as a right to a series of separate payments. </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>

</DIV></Center>


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


<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">(f) Reimbursements and <FONT STYLE="white-space:nowrap">In-Kind</FONT>
Benefits. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) Any reimbursements by Employer to Employee of any eligible expenses pursuant to Section&nbsp;3.1 or 5.8 of
this Agreement, that are not excludible from Employee&#146;s income for Federal income tax purposes (&#147;Taxable Reimbursements&#148;) shall be made on or before the last day of the taxable year of Employee following the year in which the expense
was incurred. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) The amount of any Taxable Reimbursements, and the value of any
<FONT STYLE="white-space:nowrap">in-kind</FONT> benefits to be provided to Employee under this Agreement, during any taxable year of Employee shall not affect the expenses eligible for reimbursement, or
<FONT STYLE="white-space:nowrap">in-kind</FONT> benefits to be provided, in any other taxable year of Employee. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) The
right to Taxable Reimbursements, or <FONT STYLE="white-space:nowrap">in-kind</FONT> benefits, shall not be subject to liquidation or exchange for another benefit. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.13. <I>Release. </I>Employer shall provide Employee with a general release in the form attached as Exhibit C (subject to such modifications
as Employer may reasonably request) within seven (7)&nbsp;days after Employee&#146;s termination date.&nbsp;Payments or benefits to which Employee may be entitled pursuant to this Section&nbsp;5 (other than any accrued but unpaid Base Salary and
employee benefits as of the end of the Employment Period) (the &#147;Severance Amounts&#148;) shall be conditioned upon Employee executing the general release within 21 days after receiving it from Employer and the general release becoming
irrevocable upon the expiration of 7 days following the Employee&#146;s execution of it. Payment of the Severance Amounts shall be suspended during the period (the &#147;Suspension Period&#148;) that begins on Employee&#146;s termination date and
ends on the date (&#147;Suspension Termination Date&#148;) that is thirty-five (35)&nbsp;days after Employee&#146;s termination date; provided, however, that this suspension shall not apply, and Employer shall be required to provide, any continued
health insurance coverage that would be required under Section&nbsp;5.9 hereof during the Suspension Period. If Employee executes the general release and the general release becomes irrevocable by no later than the Suspension Termination Date, then
payment of any Severance Amounts that were suspended pursuant to this provision shall be made in the first payroll period that follows the Suspension Termination Date, and any Severance Amounts that are payable after the Suspension Termination Date
shall be paid at the times provided in Section&nbsp;5. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.14. <I>Vesting of Incentive Awards. </I>Notwithstanding any contrary provision
in this Agreement or<B> </B>any Equity Plan then maintained by MEDNAX, Inc.: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) all Equity Awards granted to Employee by
MEDNAX, Inc. prior to termination of this Agreement shall continue to vest until fully vested following a termination of Employee&#146;s employment pursuant to Section&nbsp;4.2, 4.3, and 4.5;<B> </B>and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) in the event of a Change in Control after the date of this Agreement: </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) if, prior to the one (1)&nbsp;year anniversary of the effective date of such Change in Control, the employment by MEDNAX,
Inc. or its affiliates or successors of both Roger J. Medel, M.D. and Joseph M. Calabro is terminated for any reason, or they both no longer hold the positions they held just prior to the </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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:8%; font-size:10pt; font-family:Times New Roman">
Change in Control (and neither holds the top executive position in the company), then the Equity Awards granted to the Employee that are outstanding (the &#147;Accelerated Awards&#148;) shall
become fully vested and payable to the Employee on the first anniversary of the effective date of such Change in Control; provided, however, that any portion of the Accelerated Awards that is scheduled to become vested and payable pursuant to its
terms prior to the first anniversary of such Change in Control shall become vested and payable to the Employee pursuant to its terms; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) if, after the one (1)&nbsp;year anniversary of the effective date of such Change in Control, the employment by MEDNAX,
Inc. or its affiliates or successors of both Roger J. Medel, M.D. and Joseph M. Calabro is terminated for any reason, or they both no longer hold the positions they held just prior to the Change in Control (provided that neither holds the top
executive position in the company), then the Accelerated Awards shall become fully vested and payable to the Employee on the one (1)&nbsp;year anniversary of the termination date, or date of the change in position of Roger J. Medel, M.D. or Joseph
M. Calabro, whichever termination date or date in change of position is later; provided, however, that any portion of the Accelerated Awards that is scheduled to become vested and payable pursuant to its terms prior to the one (1)&nbsp;year
anniversary of such termination date or date of change in position shall become vested and payable to the Employee pursuant to its terms; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">provided in the
case of both clauses (i)&nbsp;and (ii) above, that the Employee remains in Continuous Service (as defined in the applicable Equity Plan) from the date of this Agreement through the date on which such Accelerated Awards would vest pursuant to clauses
(i)&nbsp;or (ii) above, as applicable. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(iii) if at any time after a Change in Control after the date of this Agreement, Employee&#146;s
employment is terminated pursuant to Section&nbsp;4.4 or 4.7(a),(b)(d)&nbsp;(e) or (f), then all of the Accelerated Awards will be fully vested and exercisable as of the effective date of such termination. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Notwithstanding anything to the contrary in this Agreement, the Equity Plans or the Equity Awards, in the event of a Change in Control
immediately following which neither the common stock of MEDNAX, Inc. nor the common equity of its successor, parent or subsidiary is listed for trading on a national securities exchange (a &#147;Going Private Transaction&#148;), then all unvested
Equity Awards granted to the Employee shall be adjusted so that in lieu of the Employee&#146;s right to receive shares of common stock of MEDNAX, Inc. pursuant to the terms of such Equity Awards, the Employee shall be entitled to receive, for each
share of common stock of MEDNAX, Inc. that Employee would otherwise be entitled to receive pursuant to such Equity Awards, an amount of cash equal to the amount per share of common stock of MEDNAX, Inc. paid to the shareholders of MEDNAX, Inc. in
such Going Private Transaction, as determined by the Compensation Committee of the Board in its sole discretion, in each case consistent with the vesting schedule of such Equity Awards and shall remain subject to the acceleration provisions set
forth in this Section&nbsp;5.14. </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>

</DIV></Center>


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


<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"><B>6. Successors; Binding Agreement. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">6.1. <I>Successors</I>. Employer shall require any successor (whether direct or indirect, by purchase, merger, consolidation or otherwise)
acquiring a majority of Employer&#146;s voting common stock or any other successor to all or substantially all of the business and/or assets of Employer to expressly assume and agree to perform this Agreement in the same manner and to the same
extent that Employer would be required to perform it if no such succession had taken place and Employee hereby consents to any such assignment. In such event, &#147;Employer&#148; shall mean Employer as previously defined and any successor to its
business and/or assets which executes and delivers the agreement provided for in this Section&nbsp;6 or which otherwise becomes bound by all the terms and provisions of this Agreement by operation of law. This Section shall not limit Employee&#146;s
ability to terminate this Agreement in the circumstances described in Section&nbsp;4.7 in the event of a Change in Control. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">6.2.
<I>Benefit</I>. This Agreement and all rights of Employee under this Agreement shall inure to the benefit of and be enforceable by Employee&#146;s personal or legal representatives, executors, administrators, successors, heirs, distributees,
devisees and legatees. If Employee should die after the termination date and amounts would have been payable to Employee under this Agreement if Employee had continued to live, including under Section&nbsp;5 hereof, then such amounts shall be paid
to Employee&#146;s devisee, legatee, or other designee or, if there is no such designee, Employee&#146;s estate. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>7.</B> <B>Conflicts.
</B>This Agreement constitutes the entire agreement among the parties pertaining to the subject matter hereof, and supersedes and revokes any and all prior or existing agreements, written or oral, relating to the subject matter hereof, and this
Agreement shall be solely determinative of the subject matter hereof. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>8. Restrictive Covenants; Confidential Information; Work
Product; Injunctive Relief. </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.1. <I>No Material Competition</I>. Employer and Employee acknowledge and agree that a strong
relationship and connection exists between Employer and its current and prospective patients, referral sources, and customers as well as the hospitals and healthcare facilities at which it provides professional services. Employer and Employee
further acknowledge and agree that the restrictive covenants described in this Section are designed to enforce, and are ancillary to or part of, the promises contained in this Agreement and are reasonably necessary to protect the legitimate
interests of Employer in the following: (1)&nbsp;the use and disclosure of the Confidential Information as described in Section&nbsp;8.4; (2) the professional development activities described in Section&nbsp;1.2; and (3)&nbsp;the goodwill of the
Employer, as promoted by Employee as provided in Section&nbsp;1.2. The foregoing listing is by way of example only and shall not be construed to be an exclusive or exhaustive list of such interests. Employee acknowledges that the restrictive
covenants set forth below are of significant value to Employer and were a material inducement to Employer in agreeing to the terms of this Agreement. Employee further acknowledges that the goodwill and other proprietary interest of Employer will
suffer irreparable and continuing damage in the event Employee enters into competition with Employer in violation of this Section. </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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Therefore, Employee agrees that, except with respect to services performed under this Agreement on behalf of
Employer, <B>Employee shall not</B>, at any time during the Restricted Period (as defined below), for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer, participate or engage in or own an interest in,
directly or indirectly, any individual proprietorship, partnership, corporation, joint venture, trust or other form of business entity, whether as an individual proprietor, partner, joint venturer, officer, director, member, employee, consultant,
independent contractor, stockholder, lender, landlord, finder, agent, broker, trustee, or in any manner whatsoever, if such entity or its affiliates is engaged in, directly or indirectly, &#147;Employer&#146;s Business,&#148; as defined on Exhibit A
hereto. Employee acknowledges that, as of the date hereof, Employee&#146;s responsibilities will include matters affecting the businesses of Employer listed on Exhibit A. For purposes of this Section&nbsp;8, the &#147;Restricted Period&#148; shall
mean the Employment Period plus (i)&nbsp;eighteen (18) months in the event this Agreement is terminated pursuant to Sections 4.1, (ii) thirty (30)&nbsp;months in the event the Agreement is terminated pursuant to Section&nbsp;4.7 following a Change
in Control, and (iii)&nbsp;twenty-four (24)&nbsp;months in the event the Agreement is terminated for any other reason. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.2. <I>No
Hire</I>. Employee further agrees that <B>Employee shall not</B>, at any time during the Employment Period and for a period of eighteen (18)&nbsp;months immediately following termination of this Agreement for any reason, for Employee or on behalf of
any other person, persons, firm, partnership, corporation or employer, intentionally, knowingly, or willingly employ, or intentionally, knowingly, or willingly permit any company or business directly or indirectly controlled by Employee to employ or
otherwise engage (a)&nbsp;any person who is a then current employee or independent contractor of Employer or one of its affiliates, or (b)&nbsp;any person who was an employee or independent contractor of Employer or one of its affiliates in the
prior six (6)&nbsp;month period, or in any manner seek to induce such persons to leave his or her employment or engagement with Employer or one of its affiliates (including without limitation for or on behalf of a subsequent employer of Employee).
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.3 <I><FONT STYLE="white-space:nowrap">Non-solicitation.</FONT> </I>Employee further agrees that <B>Employee shall not</B>, at any time
during the Employment Period and for a period of eighteen (18)&nbsp;months immediately following termination of this Agreement for any reason, for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer,
solicit or accept business from or take any action that would interfere with, diminish or impair the valuable relationships that Employer or its affiliates have with (i)&nbsp;hospitals or other health care facilities with which Employer or its
affiliates have contracts to render professional services or otherwise have established relationships, (ii)&nbsp;patients, (iii) referral sources, (iv)&nbsp;vendors, (v) any other clients of Employer or its affiliates, or (vi)&nbsp;prospective
hospitals, patients, referral sources, vendors or clients whose business Employee was aware that Employer or any affiliate of Employer was in the process of soliciting at the time of Employee&#146;s termination (including potential acquisition
targets). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.4. <I>Confidential Information</I>. At all times during the term of this Agreement, Employer shall provide Employee with
access to &#147;Confidential Information.&#148; As used in this Agreement, the term &#147;Confidential Information&#148; means any and all confidential, proprietary or trade secret information, whether disclosed, directly or indirectly, verbally, in
writing or by any other means in tangible or intangible form, including that which is conceived or developed by </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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
Employee, applicable to or in any way related to: (i)&nbsp;patients with whom Employer has a physician/patient relationship; (ii)&nbsp;the present or future business of Employer; or
(iii)&nbsp;the research and development of Employer. Without limiting the generality of the foregoing, Confidential Information includes: (a)&nbsp;the development and operation of Employer&#146;s medical practices, including information relating to
budgeting, staffing needs, marketing, research, hospital relationships, equipment capabilities, and other information concerning such facilities and operations and specifically including the procedures and business plans developed by Employer for
use at the hospitals where Employer conducts its business; (b)&nbsp;contractual arrangements between the Employer and insurers or managed care associations or other payors; (c)&nbsp;the databases of Employer; (d)&nbsp;the clinical and research
protocols of Employer, including coding guidelines; (e)&nbsp;the referral sources of Employer; (f)&nbsp;other confidential information of Employer that is not generally known to the public that gives Employer the opportunity to obtain an advantage
over competitors who do not know or use it, including the names, addresses, telephone numbers or special needs of any of its patients, its patient lists, its marketing methods and related data, lists or other written records used in Employer&#146;s
business, compensation paid to employees and other terms of employment, accounting ledgers and financial statements, contracts and licenses, business systems, business plan and projections, and computer programs. The parties agree that, as between
them, this Confidential Information constitutes important, material, and confidential trade secrets that affect the successful conduct of Employer&#146;s business and its goodwill. Employer acknowledges that the Confidential Information specifically
enumerated above is special and unique information and is not information that would be considered a part of the general knowledge and skill Employee has or might otherwise obtain. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Notwithstanding the foregoing, Confidential Information shall not include any information that (i)&nbsp;was known by Employee from a third
party source before disclosure by or on behalf of Employer, (ii)&nbsp;becomes available to Employee from a source other than Employer that is not, to Employee&#146;s knowledge, bound by a duty of confidentiality to Employer, (iii)&nbsp;becomes
generally available or known in the industry other than as a result of its disclosure by Employee, or (iv)&nbsp;has been independently developed by Employee and may be disclosed by Employee without breach of this Agreement, provided, in each case,
that the Employee shall bear the burden of demonstrating that the information falls under one of the above-described exceptions. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Employee
agrees that the terms of this Agreement shall be deemed Confidential Information for purposes of this Section. Employee shall keep the terms of this Agreement strictly confidential and will not, without the prior written consent of Employer,
disclose the details of this Agreement to any third party in any manner whatsoever in whole or in part, with the exception of Employee&#146;s representatives (such as tax advisors and attorneys) who need to know such information. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Employee agrees that Employee will not at any time, whether during or subsequent to the term of Employee&#146;s employment with Employer, in
any fashion, form or manner, unless specifically consented to in writing by Employer, either directly or indirectly, use or divulge, disclose, or communicate to any person, firm or corporation, in any manner whatsoever, any Confidential Information
of any kind, nature, or description, subject to applicable law. The parties agree that any breach by Employee of any term of this Section is a material breach of this Agreement and shall constitute &#147;cause&#148; for the termination of
Employee&#146;s employment hereunder. In the event that Employee is ordered to disclose any Confidential Information, whether in a legal </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
or a regulatory proceeding or otherwise, Employee shall provide Employer with prompt written notice of such request or order so that Employer may seek to prevent disclosure or, if that cannot be
achieved, the entry of a protective order or other appropriate protective device or procedure in order to assure, to the extent practicable, compliance with the provisions of this Agreement. In the case of any disclosure required by law, Employee
shall disclose only that portion of the Confidential Information that Employee is ordered to disclose in a legally binding subpoena, demand or similar order issued pursuant to a legal or regulatory proceeding. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">All Confidential Information, and all equipment, notebooks, documents, memoranda, reports, files, samples, books, correspondence, lists, other
written and graphic records, in any media (including electronic or video) containing Confidential Information or relating to the business of Employer, which Employee shall prepare, use, construct, observe, possess, or control shall be and remain
Employer&#146;s sole property (collectively &#147;Employer Property&#148;). Upon termination or expiration of this Agreement, or earlier upon Employer&#146;s request, Employee shall promptly deliver to Employer all Employer Property, retaining none.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.5. <I>Ownership of Work Product.</I> Employee agrees and acknowledges that (i)&nbsp;all copyrights, patents, trade secrets, trademarks,
service marks, or other intellectual property or proprietary rights associated with any ideas, concepts, techniques, inventions, processes, or works of authorship developed or created by Employee during the course of performing work for Employer and
any other work product conceived, created, designed, developed or contributed by Employee during the term of this Agreement that relates in any way to Employer&#146;s Business (collectively, the &#147;Work Product&#148;), shall belong exclusively to
Employer and shall, to the extent possible, be considered a work made for hire within the meaning of Title 17 of the United States Code. To the extent the Work Product may not be considered a work made for hire owned exclusively by Employer,
Employee hereby assigns to Employer all right, title, and interest worldwide in and to such Work Product at the time of its creation, without any requirement of further consideration. Upon request of Employer, Employee shall take such further
actions and execute such further documents as Employer may deem necessary or desirable to further the purposes of this Agreement, including without limitation separate assignments of all right, title, and interest in and to all rights of copyright
and all right, title, and interest in and to any inventions or patents and any reissues or extensions which may be granted therefore, and in and to any improvements, additions to, or modifications thereto, which Employee may acquire by invention or
otherwise, the same to be held and enjoyed by Employer for its own use and benefit, and for the use and benefit of Employer&#146;s successors and assigns, as fully and as entirely as the same might be held by Employee had this assignment not been
made. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.6. <I>Clearance Procedure for Proprietary Rights Not Claimed by Employer.</I> In the event that Employee wishes to create or
develop, <I>other than</I> on Employer&#146;s time or using Employer&#146;s resources, anything that may be considered Work Product but to which Employee believes Employee should be entitled to the personal benefit of, Employee agrees to follow the
clearance procedure set forth in this Section. Before beginning any such work, Employee agrees to give Employer advance written notice and provide Employer with a sufficiently detailed written description of the work under consideration for Employer
to make a determination regarding the work. Unless otherwise agreed in a writing signed by Employer prior to receipt, Employer shall have no obligation of confidentiality with respect to such request or description. Employer will
</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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
determine in its sole discretion, within thirty (30)&nbsp;days after Employee has fully disclosed such plans to Employer, whether rights in such work will be claimed by Employer. If Employer
determines that it does not claim rights in such work, Employer agrees to so notify Employee in writing and Employee may retain ownership of the work to the extent that such work has been expressly disclosed to Employer. If Employer fails to so
notify Employee within such thirty (30)&nbsp;day period, then Employer shall be deemed to have agreed that such work is not considered Work Product for purposes of this Agreement. Employee agrees to submit for further review any significant
improvement, modification, or adaptation that could reasonably be related to Employer&#146;s Business so that it can be determined whether the improvement, modification, or adaptation relates to the business or interests of Employer. Clearance under
this procedure does not relieve Employee of the restrictive covenants set forth in this Section&nbsp;8. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.7. <I><FONT
STYLE="white-space:nowrap">Non-Disparagement.</FONT></I> For a period of ten (10)&nbsp;years after the termination of this Agreement, Employee will not, directly or indirectly, as an individual or on behalf of a firm, corporation, partnership or
other legal entity, make any disparaging or negative comment to any other person or entity regarding Employer or any of its affiliates, agents, attorneys, employees, officers and directors, Employee&#146;s work conditions or circumstances
surrounding Employee&#146;s separation from Employer or otherwise impugn or criticize the name or reputation of Employer, its affiliates, agents, attorneys, employees, officers or directors, orally or in writing. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.8. <I>Review by Employee.</I> <B>Employee has carefully read and considered the terms and provisions of this Section</B><B></B><B>&nbsp;8,
and having done so, agrees that the restrictions set forth in this Section</B><B></B><B>&nbsp;8 are fair and reasonably required for the protection of the interests of Employer.</B> In the event that any term or provision set forth in this
Section&nbsp;8 shall be held to be invalid or unenforceable by a court of competent jurisdiction, the parties hereto agree that such invalid or unenforceable term(s) or provision(s) may be severed from this Agreement without, in any manner,
affecting the remaining portions hereof. Without limiting other possible remedies available to Employer, Employee agrees that injunctive or other equitable relief will be available to enforce the covenants set forth in this Section, such relief to
be without the necessity of posting a bond. In the event that, notwithstanding the foregoing, any part of the covenants set forth in this Section shall be held to be invalid, overbroad, or unenforceable by an arbitration panel or a court of
competent jurisdiction, the parties hereto agree that such invalid, overbroad, or unenforceable provision(s) may be modified or severed from this Agreement without, in any manner, affecting the remaining portions of this Section&nbsp;8 (all of which
shall remain in full force and effect). In the event that any provision of this Section&nbsp;8 related to time period or areas of restriction shall be declared by an arbitration panel or a court of competent jurisdiction to exceed the maximum time
period, area or activities such arbitration panel or court deems reasonable and enforceable, said time period or areas of restriction shall be deemed modified to the minimum extent necessary to make the geographic or temporal restrictions or
activities reasonable and enforceable. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.9. <I>Survival.</I> The provisions of this Section&nbsp;8 shall survive the termination of this
Agreement and Employee&#146;s employment with Employer.<B> </B>The provisions of this Section&nbsp;8 shall apply during the time Employee is receiving Disability payments from Employer as a result of a termination of this Agreement pursuant to
Section&nbsp;4.2 hereof.<B> </B>In the event of a breach of this Section&nbsp;8 by Employee, Employer retains the right to terminate any continuing payments to Employee provided for in Section&nbsp;5 of this Agreement. The provisions of this
Section&nbsp;8 are expressly intended to benefit and be enforceable by other affiliated entities of Employer, who are express third party beneficiaries hereof. Employee shall not assist others in engaging in any of the activities described in the
foregoing restrictive covenants. </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">17 </P>

</DIV></Center>


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


<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"><B>9.</B> <B>Arbitration. </B>Any controversy or claim arising out of or relating to this
Agreement, or any alleged breach hereof shall be finally determined by a single arbitrator, jointly selected by the Employee and Employer, provided that if Employee and Employer are unable to agree upon a single arbitrator after reasonable efforts,
the arbitrator shall be an impartial arbitrator selected by the American Arbitration Association. Each party hereto shall share equally the costs of the arbitrator, and the parties agree that the costs of arbitration shall not be subject to
reapportionment by the arbitrator; <U>provided, however</U>, that if following a termination of Employee&#146;s employment that follows a Change in Control or if following a termination of Employee&#146;s employment for Good Reason that follows any
person other than Roger J. Medel or Joseph M. Calabro commencing service as the senior most executive officer of Mednax, Employee seeks arbitration to enforce the terms of this Agreement, Employer shall bear all costs associated with such
arbitration, including but not limited to all costs of the arbitrator, and shall reimburse Employee on a monthly basis for his reasonable legal and other expenses, including all fees, incurred in connection with any such arbitration. The arbitration
proceedings shall be held in Sunrise, Florida, unless otherwise mutually agreed by the parties, and shall be conducted in accordance with the American Arbitration Association National Rules for the Resolution of Employment Disputes then in effect.
Judgment on the award rendered by the arbitration panel may be entered and enforced by any court having jurisdiction thereof. Any such arbitration shall be treated as confidential by all parties thereto, except as otherwise provided by law or as
otherwise necessary to enforce any judgment or order issued by the arbitrators. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding anything herein to the contrary, if
Employer or Employee shall require immediate injunctive relief, then the party shall be entitled to seek such relief in any court having jurisdiction, and if the party elects to do so, the other party hereby consents to the jurisdiction of the state
and federal courts sitting in the State of Florida and to the applicable service of process. Employee and Employer hereby waive and agree not to assert, to the fullest extent permitted by applicable law, any claim that (i)&nbsp;they are not subject
to the jurisdiction of such courts, (ii)&nbsp;they are immune from any legal process issued by such courts and (iii)&nbsp;any litigation or other proceeding commenced in such courts is brought in an inconvenient forum. In the event that either party
hereto brings suit seeking injunctive relief, the party found to be at fault shall pay all reasonable court costs and attorneys&#146; fees of the other, whether such costs and fees are incurred in a court of original jurisdiction or one or more
courts of appellate jurisdiction. Notwithstanding the foregoing, in the event that Employer brings suit against Employee seeking injunctive relief, Employer agrees to advance all of Employee&#146;s reasonable legal and other expenses, including all
fees, incurred by the Employee in connection with such action, provided, however, that if Employer ultimately prevails in seeking injunctive relief, Employee shall reimburse Employer all such advanced legal fees and other expenses. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>10.</B> <B>Governing Law.</B> This Agreement shall be governed by and construed in accordance with the laws of the State of Florida without
regard to its conflict of laws principles to the extent that such principles would require the application of laws other than the laws of the State of Florida. </P>
 <p STYLE="margin-top: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>

</DIV></Center>


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


<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"><B>11.</B> <B>Notices.</B> Any notice required or permitted to be given under this Agreement
shall be in writing and shall be deemed to have been given when delivered by hand or when deposited in the United States mail by registered or certified mail, return receipt requested, postage prepaid, addressed as follows: </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="84%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="51%"></TD>
<TD VALIGN="bottom" WIDTH="3%"></TD>
<TD WIDTH="46%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">If to Employer:</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">If to Employee:</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">Mednax Services, Inc.</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">1301 Concord Terrace</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">1301 Concord Terrace</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">Sunrise, FL 33323</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">Sunrise, FL 33323</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">Attention: President</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">or to such other addresses as either party hereto may from time to time give notice of to the other in the aforesaid manner.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>12.</B> <B>Benefits: Binding Effect.</B> This Agreement shall be for the benefit of and binding upon the parties hereto and their
respective heirs, personal representatives, legal representatives, successors and, where applicable, assigns. Notwithstanding the foregoing, Employee may not assign the rights or benefits hereunder without the prior written consent of Employer. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>13.</B> <B>Severability. </B>The invalidity of any one or more of the words, phrases, sentences, clauses or sections contained in this
Agreement shall not affect the enforceability of the remaining portions of this Agreement or any part thereof, all of which are inserted conditionally on their being valid in law, and, in the event that any one or more of the words, phrases,
sentences, clauses or sections contained in this Agreement shall be declared invalid, this Agreement shall be construed as if such invalid word or words, phrase or phrases, sentence or sentences, clause or clauses, or section or sections had not
been inserted. If such invalidity is caused by length of time or size of area, or both, the otherwise invalid provision will be considered to be reduced to a period or area, which would cure such invalidity. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>14.</B> <B>Waivers. </B>The waiver by either party hereto of a breach or violation of any term or provision of this Agreement shall not
operate nor be construed as a waiver of any subsequent breach or violation. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>15.</B> <B>Damages. </B>Nothing contained herein shall be
construed to prevent Employer or Employee from seeking and recovering from the other damages sustained by either or both of them as a result of a breach of any term or provision of this Agreement. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>16.</B> <B>No Third Party Beneficiary. </B>Except as provided in Section&nbsp;8.9, nothing expressed or implied in this Agreement is
intended, or shall be construed, to confer upon or give any person (other than the parties hereto and, in the case of Employee, Employee&#146;s heirs, personal representative(s) and/or legal representative) any rights or remedies under or by reason
of this Agreement. No agreements or representations, oral or otherwise, express or implied, have been made by either party with respect to the subject matter of this Agreement which agreements or representations are not set forth expressly in this
Agreement, and this Agreement supersedes any other employment agreement between Employer and Employee. </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>

</DIV></Center>


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


<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"><B>17.</B> <B>Assignment.</B> This Agreement may be assigned by Employer upon notice to
Employee. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>The remainder of this page has been left blank intentionally. </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">20 </P>

</DIV></Center>


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


<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"><B>IN WITNESS WHEREOF</B>, the undersigned have executed this Agreement this 12th day of
February, 2019, effective as of the Effective Date. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


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


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>EMPLOYER:</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" COLSPAN="3"><B>EMPLOYEE:</B></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16" COLSPAN="3"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="4"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B>MEDNAX SERVICES, INC</B>.</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD COLSPAN="3" VALIGN="top"></TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD>
<TD HEIGHT="16" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Manuel Kadre</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">By:</TD>
<TD VALIGN="bottom" STYLE=" BORDER-BOTTOM:1px solid #000000">&nbsp;</TD>
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000">/s/ Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Manuel Kadre</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">Dominic J. Andreano</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top">Chairman, Compensation Committee</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></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">21 </P>

</DIV></Center>


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


<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>EXHIBIT A </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>BUSINESS OF EMPLOYER </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As
of the date hereof, Employer, directly or through its affiliates, provides professional medical services and all aspects of practice management services in medical practice areas that include, but are not limited to, the following (collectively
referred to herein as &#147;Employer&#146;s Business&#148;): </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(1) Neonatology, including hospital well baby care; </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(2) Maternal-Fetal Medicine, including general obstetrics services; </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(3) Pediatric Cardiology; </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(4) Pediatric Intensive Care,
including Pediatric Hospitalist Care; </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(5) Newborn hearing screening services; </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(6) Pediatric Surgery; </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(7) Pediatric Emergency Medicine; </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(8) Anesthesiology, critical care medicine and pain management; and </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(9) Radiology and Teleradiology. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">References to
Employer&#146;s Business in this Agreement shall include such other medical service lines, practice management services and other businesses in which Employer is engaged during the Employment Period; <I>provided,</I> that to be considered a part of
Employer&#146;s Business, Employer must have engaged in such other service line, practice management service or other business at least six (6)&nbsp;months prior to the termination date of this Agreement. For purposes of this Exhibit A, businesses
of Employer shall include the businesses conducted by Employer&#146;s subsidiaries, entities under common control and affiliates as defined under Rule 144 of the Securities Act of 1933, as amended. Such affiliates shall include the professional
corporations and associations whose operating results are consolidated with Employer for financial reporting purposes. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding
the foregoing, Employer acknowledges and agrees to the following exceptions and clarifications regarding the scope of Employer&#146;s Business. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">A. <I>Hospital Services. </I>Employer and Employee acknowledge that, as of the date hereof, Employer does not currently operate hospitals,
hospital systems or universities. Nevertheless, the businesses of hospitals, hospital systems and universities would be the same as Employer&#146;s Business where such hospitals, hospital systems or universities provide or contract with others to
provide some or all of the medical services included in Employer&#146;s Business. Therefore, the parties desire to clarify their intent with respect to the limitations on Employee&#146;s ability to work for or contract with others to provide
services for a hospital, hospital system or university during the Employment Period and during the Restricted Period. Section&nbsp;8.1 shall not be deemed to restrict Employee&#146;s ability to work for a hospital, hospital system or university if
the hospital, hospital system or university does not provide any of the medical services included in Employer&#146;s Business. Furthermore, even if a hospital, hospital system or university provides medical services that are included in
Employer&#146;s Business, Employee may work for such hospital, </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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
hospital system or university if Employee has no direct supervisory responsibility for or involvement in the hospital&#146;s, hospital system&#146;s or university&#146;s medical services that are
Employer&#146;s Business. Finally, Employer agrees that Employee may hold direct supervisory responsibility for or be involved in the medical services of a hospital, hospital system or university that are included in Employer&#146;s Business so long
as such hospital, hospital system or university is located at least ten (10)&nbsp;miles from a medical practice owned or operated by Employer or its affiliate. Subject to paragraph B below, the provisions of this paragraph shall not apply to the
extent that, after the date hereof, Employer enters into the business of operating a hospital or hospital system. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">B. <I>De Minimus
Exception. </I>Employer agrees that a medical service line (other than those listed in items 1 through 9 above), practice management service or other business in which Employer is engaged shall not be considered to be a part of Employer&#146;s
Business if such medical service line, practice management service or other business constitutes less than three percent (3%) of Employer&#146;s annual revenues. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">C. <I>Certain Ownership Interests. </I><B></B>It shall not be deemed to be a violation of Section&nbsp;8.1 for Employee to: (i)&nbsp;own,
directly or indirectly, one percent (1%) or less of a publicly-traded entity that has a market capitalization of $1&nbsp;billion or more; (ii)&nbsp;own, directly or indirectly, five percent (5%) or less of a publicly-traded entity that has a market
capitalization of less than $1&nbsp;billion; or (iii)&nbsp;own, directly or indirectly, less than ten percent (10%) of a privately-held business or company, if Employee is at all times a passive investor with no board representation, management
authority or other special rights to control operations of such business or company. </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">23 </P>

</DIV></Center>


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


<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>EXHIBIT B </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>COMPENSATION </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Performance Bonus:</B>
Target of One Hundred Percent (100%) of Employee&#146;s Base Salary with a Maximum Bonus potential of Two Hundred Percent (200%) of Employee&#146;s Base Salary </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Equity Compensation: </B>Employee&#146;s annual equity compensation grant target amount shall be at least $1,050,000, subject to the approval of the
Compensation Committee of the Board of Directors. </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">24 </P>

</DIV></Center>


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


<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>EXHIBIT C </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FORM OF RELEASE </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><I>GENERAL RELEASE OF CLAIMS </I></B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">1. _______________ (&#147;<U>Employee</U>&#148;), for himself and his family, heirs, executors, administrators, legal representatives and
their respective successors and assigns, in exchange for the consideration received pursuant to Section&nbsp;5.[ ] of the Employment Agreement to which this release is attached as Exhibit C (the &#147;<U>Employment Agreement</U>&#148;), does hereby
release and forever discharge _____________________ (&#147;<U>Employer</U>&#148;), its subsidiaries, affiliated companies, successors and assigns, and its current or former directors, officers, employees, shareholders or agents in such capacities
(collectively with Employer, the &#147;<U>Released Parties</U>&#148;) from any and all actions, causes of action, suits, controversies, claims and demands whatsoever, for or by reason of any matter, cause or thing whatsoever, whether known or
unknown including, but not limited to, all claims under any applicable laws arising under or in connection with Employee&#146;s employment or termination thereof, whether for discrimination, harassment, retaliation, tort, breach of express or
implied employment contract, wrongful discharge, intentional infliction of emotional distress, or defamation or injuries incurred on the job or incurred as a result of loss of employment. Employee acknowledges that Employer encouraged him to consult
with an attorney of his choosing, and through this General Release of Claims encourages Employee to consult with his attorney with respect to possible claims under the Age Discrimination in Employment Act (&#147;<U>ADEA</U>&#148;) and that he
understands that the ADEA is a Federal statute that, among other things, prohibits discrimination on the basis of age in employment and employee benefits and benefit plans. Without limiting the generality of the release provided above, Employee
expressly waives any and all claims under ADEA that he may have as of the date hereof. Employee further understands that by signing this General Release of Claims he is in fact waiving, releasing and forever giving up any claim under the ADEA as
well as all other laws within the scope of this paragraph 1 that may have existed on or prior to the date hereof. Notwithstanding anything in this paragraph 1 to the contrary, this General Release of Claims shall not apply to (i)&nbsp;any actions to
enforce rights to receive any payments or benefits which may be due Employee pursuant to Section&nbsp;5.[&nbsp;&nbsp;&nbsp;&nbsp; ] of the Employment Agreement, or under any of Employer&#146;s employee benefit plans, (ii)&nbsp;any rights or claims
that may arise as a result of events occurring after the date this General Release of Claims is executed, (iii)&nbsp;any indemnification rights Employee may have as a former officer or director of Employer or its subsidiaries or affiliated
companies, (iv)&nbsp;any claims for benefits under any directors&#146; and officers&#146; liability policy maintained by Employer or its subsidiaries or affiliated companies in accordance with the terms of such policy, and (v)&nbsp;any rights as a
holder of equity securities of Employer. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">2. Employee represents that he has not filed against the Released Parties any complaints,
charges, or lawsuits arising out of his employment, or any other matter arising on or prior to the date of this General Release of Claims, and covenants and agrees that he will never individually or with any person file, or commence the filing of,
any charges, lawsuits, complaints or proceedings with any governmental agency, or against the Released Parties with respect to any of the matters released by Employee pursuant to paragraph 1 hereof (a &#147;<U>Proceeding</U>&#148;). </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">25 </P>

</DIV></Center>


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


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


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


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000"> &nbsp;<P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:3pt">&nbsp;</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE="font-size:18pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">_______________, 20__</P></TD></TR>
</TABLE></DIV>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">26 </P>

</DIV></Center>

</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-10.37
<SEQUENCE>5
<FILENAME>d671465dex1037.htm
<DESCRIPTION>EX-10.37
<TEXT>
<HTML><HEAD>
<TITLE>EX-10.37</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 10.37 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>EMPLOYMENT AGREEMENT </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>THIS EMPLOYMENT AGREEMENT</B> (this &#147;Agreement&#148;) is made and entered into by and between <B>MEDNAX SERVICES, INC.</B>, a Florida
corporation (&#147;Employer&#148;) and <B>DAVID A. CLARK</B> (&#147;Employee&#148;) effective as the Effective Date. </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>RECITALS </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>WHEREAS</B>,<B> </B>Employer is presently engaged in &#147;Employer&#146;s Business&#148; as defined on Exhibit A hereto; and </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>WHEREAS</B>, Employee has previously served in various management positions with the Employer, it&#146;s predecessor company and their
affiliates, and is receiving a promotion to Chief Operating Officer of Employer as of the Effective Date of this Agreement; and </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>WHEREAS</B>, Employer and Employee previously entered in an Employment Agreement dated February&nbsp;12, 2018<B> </B>(the &#147;Prior
Employment Agreement&#148;), which will be superseded in its entirety upon the execution of this Agreement; and </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>WHEREAS</B>, Employer
desires to continue to employ Employee and benefit from Employee&#146;s contributions to Employer; and </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>WHEREAS</B>, in order to induce
Employer to enter into this Agreement on the terms and conditions set forth herein (including an increase in compensation over what was provided under the Prior Employment Agreement), and disclose its trade secrets and confidential information in
connection with Employee&#146;s employment by Employer and award from time to time equity based compensation, Employee hereby agrees to be bound by the terms of this Agreement, including the arbitration,
<FONT STYLE="white-space:nowrap">non-competition</FONT> and related restrictive covenants set forth herein. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>NOW, THEREFORE</B>, in
consideration of the premises and mutual covenants set forth herein, the parties agree as follows: </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>1. Employment. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">1.1. <I>Employment and Term</I>. Employer hereby agrees to employ Employee and Employee hereby agrees to serve Employer on the terms and
conditions set forth herein for an &#147;Initial Term&#148; commencing February&nbsp;12, 2019<B> </B>(the &#147;Effective Date&#148;) and continuing for a period of three (3)&nbsp;years, unless sooner terminated as hereinafter set forth. Thereafter,
the employment of Employee hereunder shall automatically renew for successive one (1)&nbsp;year periods until terminated in accordance herewith. The Initial Term and any automatic renewals shall be referred to as the &#147;Employment Period.&#148;
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">1.2. <I>Duties of Employee</I>. During the Employment Period, Employee shall serve as Chief Operating Officer for Employer and perform
such duties as are customary to the position Employee holds or as may be assigned to Employee from time to time by Employee&#146;s supervisor </P>
</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
(&#147;Employee&#146;s Supervisor&#148;); <I>provided, </I>that such duties as assigned shall be customary to Employee&#146;s role as an officer of Employer. Employee&#146;s employment shall be
full-time and as such Employee agrees to devote substantially all of Employee&#146;s attention and professional time to the business and affairs of Employer. Employee shall perform Employee&#146;s duties honestly, diligently, competently, in good
faith and in the best interest of Employer. Employee will devote best efforts to the promotion of the goodwill of Employer and of its employees and affiliates. During the Employment Term, Employer shall promote the proficiency of Employee by, among
other things, providing Employee with Confidential Information, specialized professional development programs, and information regarding the organization, administration and operation of Employer. During the Employment Period, Employee agrees that
Employee will not, without the prior written consent of Employer (which consent shall not be unreasonably withheld), serve as a director on a corporate board of directors or in any other similar capacity for any institution other than Employer.
During the Employment Period, it shall not be a violation of this Agreement to (i)&nbsp;serve on civic or charitable boards or committees, or (ii)&nbsp;deliver lectures, fulfill speaking engagements or teach at educational institutions, so long as
such activities have been approved by Employer&#146;s General Counsel and do not interfere with the performance of Employee&#146;s responsibilities as an employee of Employer in accordance with this Agreement, including the restrictions of
Section&nbsp;8 hereof. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">1.3. <I>Place of Performance</I>. Employee shall be based at Employer&#146;s offices located in Sunrise, Florida,
except for required travel relating to Employer&#146;s Business. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>2. Base Salary and Performance Bonus. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">2.1. <I>Base Salary</I>. Employee shall be paid an annual base salary as determined by Employee&#146;s supervisor from time to time (the
&#147;Base Salary&#148;), payable in installments consistent with Employer&#146;s customary payroll schedule and subject to applicable withholding for taxes and other Employee directed withholdings. Any increase to Employee&#146;s Base Salary that
is approved by Employee&#146;s Supervisor shall become Employee&#146;s new Base Salary for purposes of this Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">2.2.
<I>Performance Bonus</I>. Employee shall be eligible for an annual bonus in accordance with the incentive programs approved from time to time by the Compensation Committee, which programs shall contemplate a target bonus payment of at least the
amount set forth on Exhibit B (the &#147;Performance Bonus&#148;) based upon the fulfillment of reasonable performance objectives set by the Compensation Committee. Except in the situations described in Sections 5.2, 5.3, 5.4, 5.5 and 5.7, the
Performance Bonus shall only be payable to Employee if Employee is employed with Employer as of the date that the Performance Bonus is paid by Employer. Each Performance Bonus shall be paid in the calendar year immediately following the calendar
year in which it is earned, as soon as practicable after the audited financial statements for Employer for the year for which the bonus is earned have been released; provided, however, that if calculation of Employee&#146;s Performance Bonus is not
administratively practicable due to events beyond the control of Employer, then Employer may delay payment of the Performance Bonus provided that the payment is made during the first taxable year of Employee in which the calculation of the amount of
the payment is administratively practicable. </P>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">2 </P>

</DIV></Center>


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


<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"><B>3. Benefits. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">3.1. <I>Expense Reimbursement</I>. Employer shall promptly reimburse Employee for all <FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">out-of-pocket</FONT></FONT> expenses reasonably incurred by Employee during the Employment Period on behalf of or in connection with Employer&#146;s Business pursuant to the reimbursement standards and guidelines of
Employer in effect from time to time. Employee shall account for such expenses and submit reasonable supporting documentation to Employer in accordance with Employer&#146;s policies in effect from time to time. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">3.2 <I>Employee Benefits</I>. During the Employment Period, Employee shall be entitled to participate in such health, welfare, disability,
retirement savings and other fringe benefit plans and programs (subject to the terms and conditions of such plans and programs) as may be provided from time to time to employees of Employer and to the extent that such plans and programs are
applicable to other similarly situated employees of Employer. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">3.3. <I>Leave Time</I>. During the Employment Period, Employee shall be
entitled to paid vacation and leave days each calendar year in accordance with the leave policies established by Employer from time to time, but in no event less than thirty-eight (38)&nbsp;days per year. Any leave time not used during each fiscal
year of Employer may be carried over into the next year to the extent permitted by Employer policy. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">3.4 <I>Equity Plans. </I>During the
Employment Period, Employee shall be eligible to participate in MEDNAX, Inc.&#145;s Amended and Restated 2008 Incentive Compensation Plan, as amended, or any other similar plan adopted by MEDNAX, Inc. (each an &#147;Equity Plan&#148;) that provides
for the issuance of stock options, stock appreciation rights, restricted stock, deferred stock, bonus stock, awards payable in stock or any other stock based award (each an &#147;Equity Award&#148;). Employee&#146;s stock-based award each year shall
be determined by the Compensation Committee of MEDNAX, Inc.&#146;s Board of Directors based on Employee&#146;s performance and Employer&#146;s performance during the immediately preceding year and shall be at least the amount set forth on Exhibit B
hereto. Every Equity Award made to Employee shall be subject to the terms and conditions of this Agreement, the applicable award agreement and the terms of the Equity Plan. Employee shall also be eligible to participate in MEDNAX, Inc.&#146;s <FONT
STYLE="white-space:nowrap">non-qualified</FONT> employee stock purchase plan and any successor plan. Employee acknowledges Employee&#146;s participation in the Equity Plan pursuant to this Section&nbsp;3 is sufficient consideration for Employee to
enter into this Agreement, including the restrictive covenants set forth in Section&nbsp;8 below<I>. </I> </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>4. Termination. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.1. <I>Termination for Cause</I>. Employer may terminate Employee&#146;s employment under this Agreement for Cause. As used in this
Agreement, the term &#147;Cause&#148; shall mean the occurrence of any of (i)&nbsp;Employee&#146;s engagement in (A)&nbsp;willful misconduct resulting in material harm to Mednax or Employer, or (B)&nbsp;gross negligence; (ii)&nbsp;Employee&#146;s
conviction of, or pleading nolo contendere to, a felony or any other crime involving fraud, financial misconduct, or misappropriation of Employer&#146;s assets; (iii)&nbsp;Employee&#146;s willful and continual failure, after written notice from
Employee&#146;s Supervisor or the Board to (A)&nbsp;perform substantially his employment </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
duties consistent with his position and authority, or (B)&nbsp;follow, consistent with Employee&#146;s position, duties, and authorities, the reasonable lawful mandates of Employee&#146;s
Supervisor or the Board; (iv)&nbsp;Employee&#146;s failure or refusal to comply with a reasonable policy, standard or regulation of Employer in any material respect, including but not limited to Employer&#146;s sexual harassment, other unlawful
harassment, workplace discrimination or substance abuse policies; or (v)&nbsp;Employee&#146;s breach of Section&nbsp;8.4 of this Agreement. No act or omission shall be deemed willful or grossly negligent for purposes of this definition if taken or
omitted to be taken by Employee in a good faith belief that such act or omission to act was in the best interests of Employer or Mednax or if done at the express direction of the Board of Directors of Mednax. The termination date for a termination
of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.1 shall be the date specified by Employer in a written notice to Employee of finding of Cause, which may not be retroactive. Upon termination of Employee&#146;s
employment under this Agreement pursuant to Section&nbsp;4.1, Employee shall be entitled to compensation in accordance with and subject to, the provisions of Section&nbsp;5.1 hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.2. <I>Disability</I>. Employer may terminate Employee&#146;s employment under this Agreement upon the Disability (as defined below) of
Employee. Subject to the requirements of applicable law, Employee shall be deemed to have a &#147;Disability&#148; for purposes of this Agreement in the event of (i)&nbsp;Employee&#146;s inability to perform Employee&#146;s duties hereunder, with or
without a reasonable accommodation, as a result of physical or mental illness or injury, and (ii)&nbsp;a determination by an independent qualified physician selected by Employer and acceptable to Employee (which acceptance shall not be unreasonably
withheld) that Employee is currently unable to perform such duties and in all reasonable likelihood such inability will continue for a period in excess of an additional ninety (90)&nbsp;or more days in any one hundred twenty (120)&nbsp;day period.
The termination date for a termination of this Agreement pursuant to this Section&nbsp;4.2 shall be the date specified by Employer in a notice to Employee, which date shall not be retroactive. Upon any termination of this Agreement pursuant to this
Section&nbsp;4.2, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.2 hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.3. <I>Death</I>. Employee&#146;s employment under this Agreement shall terminate automatically upon the death of Employee, without any
requirement of notice by Employer to Employee&#146;s estate. The date of Employee&#146;s death shall be the termination date for a termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.3. Upon any termination
of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.3, Employee shall be entitled to the compensation specified in Section&nbsp;5.3 hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.4. <I>Termination by Employer Without Cause</I>. Employer may terminate Employee&#146;s employment without cause by giving Employee written
notice of such termination. The termination date shall be the date specified by Employer in such notice, which may be up to ninety (90)&nbsp;days from the date of such notice. Upon any termination of Employee&#146;s employment under this Agreement
pursuant to this Section&nbsp;4.4, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.4 hereof. </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.5. <I>Termination by Employee Due to Poor Health</I>. Employee may terminate
Employee&#146;s employment under this Agreement upon written notice to Employer if Employee&#146;s health should become impaired to any extent that makes the continued performance of Employee&#146;s duties under this Agreement hazardous to
Employee&#146;s physical or mental health or Employee&#146;s life (regardless of whether such condition would be deemed a Disability under any other Section of this Agreement), <I>provided </I>that Employee shall have furnished Employer with a
written statement from a qualified doctor to that effect, and <I>provided further</I> that, at Employer&#146;s written request and expense, Employee shall submit to a medical examination by an independent qualified physician selected by Employer and
acceptable to Employee (which acceptance shall not be unreasonably withheld), which doctor shall substantially concur with the conclusions of Employee&#146;s doctor. The termination date shall be the date specified in Employee&#146;s notice to
Employer, which date may not be earlier than thirty (30)&nbsp;days nor later than ninety (90)&nbsp;days from Employer&#146;s receipt of such notice. Upon any termination of Employee&#146;s employment under this Agreement pursuant to this
Section&nbsp;4.5, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.5 hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.6. <I>Termination by Employee</I>. Employee may terminate Employee&#146;s employment under this Agreement for any reason whatsoever upon not
less than ninety (90)&nbsp;days prior written notice to Employer. Upon receipt of such notice from Employee, Employer may, at its option, require Employee to terminate employment at any time in advance of the expiration of such ninety (90)&nbsp;day
period. The termination date under this Section&nbsp;4.6 shall be the date specified by Employer, but in no event more than ninety (90)&nbsp;days after Employer&#146;s receipt of notice from Employee as contemplated by this Section. Upon any
termination of Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.6, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section&nbsp;5.6 hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">4.7. <I>Termination by Employee for Good Reason. </I>Employee may terminate Employee&#146;s employment hereunder for Good Reason. For purposes
of this Section, &#147;Good Reason&#148; shall mean: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) a decrease in Employee&#146;s Base Salary; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) a decrease in Employee&#146;s Performance Bonus opportunity as set forth on Exhibit B or a failure of the Compensation
Committee to approve an annual equity grant within the guidelines set forth on Exhibit B; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(c) within a twenty-four
(24)&nbsp;month period after a Change in Control (as defined below), Employee is either (i)&nbsp;assigned any position, duties, responsibilities or compensation that is inconsistent with the position, duties, responsibilities or compensation of
Employee prior to such Change in Control, (ii)&nbsp;required to report to any person other than the President or Chief Executive Officer of Employer in place just prior to the Change in Control (unless Employee becomes Chief Executive Officer of
Employer or its equivalent and reports directly to the Board, as defined below), or (iii)&nbsp;required to perform services under this Agreement from another location more than twenty-five (25)&nbsp;miles from Employee&#146;s location prior to the
Change in Control. For purposes of this Agreement, &#147;Change in Control&#148; shall mean (i)&nbsp;the acquisition by a person or an entity or a group of persons and entities, directly or indirectly, of more than fifty (50%) percent of MEDNAX,
Inc.&#146;s common stock in a single transaction or a series of transactions (hereinafter referred </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
to as a &#147;50% Change in Control&#148;), (ii) a merger or other form of corporate reorganization of MEDNAX, Inc. resulting in an actual or <I>de facto</I> 50% Change in Control, or
(iii)&nbsp;the failure of Applicable Directors (defined below) to constitute a majority of MEDNAX, Inc.&#146;s Board of Directors (the &#147;Board&#148;) during any two (2)&nbsp;consecutive year period after the date of this Agreement (the <FONT
STYLE="white-space:nowrap">&#147;Two-Year</FONT> Period&#148;). &#147;Applicable Directors&#148; shall mean those individuals who are members of the Board at the inception of a <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period and any new
director whose election to the Board or nomination for election to the Board was approved (prior to any vote thereon by the shareholders) by a vote of at least <FONT STYLE="white-space:nowrap">two-thirds</FONT> (2/3) of the directors then still in
office who either were directors at the beginning of the <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period at issue or whose election or nomination for election during such <FONT STYLE="white-space:nowrap">Two-Year</FONT> Period was previously
approved as provided in this sentence; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) the assignment to Employee of any position inconsistent with the present
position Employee holds, or material diminution in Employee&#146;s authority, excluding for this purpose any isolated, insubstantial and inadvertent action not taken in bad faith and which is remedied by Employer promptly after receipt of written
notice; or </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) the requirement by Employer that Employee be based in any office or location outside of the metropolitan
area where Employer&#146;s present corporate offices are located (it being understood that Employee may be presently based at another location), except for travel reasonably required in the performance of Employee&#146;s duties. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) any other action or inaction that constitutes a material breach of this Agreement by Employer. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">If Employee desires to terminate Employee&#146;s employment under this Agreement pursuant to this Section, Employee must, within one hundred eighty
(180)&nbsp;days after the occurrence of events giving rise to the Good Reason, provide Employer with a written notice describing the Good Reason in reasonable detail. If Employer fails to cure the matter cited within thirty (30)&nbsp;days after the
date of Employee&#146;s notice, then this Agreement shall terminate as of the end of such thirty (30)&nbsp;day cure period, <I>provided, however, </I>that Employer may, at its option, require Employee to terminate employment at any time in advance
of the expiration of such thirty (30)&nbsp;day cure period. If Employee terminates Employee&#146;s employment under this Agreement pursuant to this Section&nbsp;4.7, then Employee shall be entitled to compensation and/or benefits in accordance with,
and subject to, the provisions of Section&nbsp;5.7 hereof. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>5. Compensation and Benefits Upon Termination. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.1. <I>Cause</I>. If Employee&#146;s employment is terminated for Cause, Employer shall pay Employee&#146;s Base Salary through the
termination date specified in Section&nbsp;4.1 at the rate in effect at the termination date. Upon payment of such amounts, plus any amounts as may be due under Section&nbsp;5.8 below, Employer shall have no further obligation to Employee under this
Agreement. </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.2. <I>Disability</I>. In the event of Employee&#146;s Disability, Employee shall continue
to receive Employee&#146;s Base Salary for the first ninety (90)&nbsp;days of Disability. If Employee&#146;s employment is terminated pursuant to Section&nbsp;4.2 in connection with Employee&#146;s Disability, Employee shall receive Employee&#146;s
monthly Base Salary for a period of twelve (12)&nbsp;months after the termination date, plus a bonus calculated in accordance with Section&nbsp;5.11 and any amounts as may be due under Section&nbsp;5.8, 5.9 and 5.14. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.3. <I>Death</I>. Upon Employee&#146;s death during the Employment Period, Employer shall pay to the person or entity designated by Employee
in a notice filed with Employer or, if no person is designated, to Employee&#146;s estate any unpaid amounts of Base Salary to the date of Employee&#146;s death, plus any amounts as may be due under Sections 5.8, 5.11 and 5.14 below. Any payments
Employee&#146;s spouse, beneficiaries or estate may be entitled to receive pursuant to any pension plan, employee welfare benefit plan, life insurance policy, or similar plan or policy then maintained by Employer shall be determined and paid in
accordance with the written instruments governing the respective plans and policies. In the event of Employee&#146;s death during the Employment Period, Employer shall notify Employee&#146;s designee or estate of the Equity Awards held by Employee
and the procedures pursuant to which all vested stock options may be exercised and other Equity Awards may be realized under the terms applicable to such awards. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.4. <I>Termination by Employer Without Cause</I>. If Employer terminates Employee&#146;s employment in accordance with Section&nbsp;4.4, then
(i)&nbsp;Employer shall pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.4 at the rate in effect at such termination date, plus any amount due under Sections&nbsp;5.8 and 5.14 hereof; (ii)&nbsp;within thirty
(30)&nbsp;days, pay Employee a bonus calculated in accordance with Section&nbsp;5.11 hereof; (iii)&nbsp;Employer shall continue to pay Employee&#146;s monthly Base Salary for a period of twenty-four (24)&nbsp;months after the termination date;
(iv)&nbsp;within thirty (30)&nbsp;days of the first (1<SUP STYLE="font-size:85%; vertical-align:top">st</SUP>)&nbsp;anniversary of the termination date, pay Employee an amount equal to 1.5x Employee&#146;s Average Annual Performance Bonus (as
defined below); and (v)&nbsp;if applicable, Employee shall vest into the Accelerated Awards (as defined below) as set forth in Section&nbsp;5.14 hereof. For purposes of this Agreement, &#147;Average Annual Performance Bonus&#148; shall be equal to
the average of the percentage of the Performance Bonus target achieved by Employee for the three (3)&nbsp;full calendar years prior to the termination date, and calculated based on Employee&#146;s Base Salary and target Performance Bonus in
Employee&#146;s current position. <I>For illustration purposes, if Employee earned 40%, 100% and 70% of Employee&#146;s target Performance Bonus in each of the three full calendar years prior to termination, and Employee&#146;s current target
Performance Bonus was 100% of Base Salary, and Base Salary was $450,000.00, then Employee&#146;s Average Annual Performance Bonus would equal $315,000.00. ((40%+ 100% + 70%) / 3 x 100% x $450,000.00 = $315,000.00). </I> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.5. <I>Termination by Employee Due to Poor Health. </I>If Employee terminates Employee&#146;s employment under this Agreement pursuant to
Section&nbsp;4.5 hereof, Employer shall pay to Employee any unpaid amounts of Base Salary to the termination date specified in Section&nbsp;4.5, plus any disability payments otherwise payable by or pursuant to plans provided by Employer, plus any
amounts as may be due under Sections 5.8, 5.11 and 5.14 below. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.6. <I>Termination by Employee</I>. If Employee&#146;s employment under
this Agreement terminates pursuant to Section&nbsp;4.6 hereof, Employer shall pay to Employee any unpaid amounts of Base Salary to the termination date specified in Section&nbsp;4.6, plus any amounts as may be due under Section&nbsp;5.8 below. In
the event that the termination date specified by Employer is less than ninety (90)&nbsp;days after the date of Employer&#146;s receipt of notice as contemplated by Section&nbsp;4.6, then Employer shall continue Employee&#146;s Base Salary for a
period of days equal to ninety (90)&nbsp;minus the number of days from Employee&#146;s notice to the termination date. </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.7. <I>Termination for Good Reason.</I><B> </B>If Employee&#146;s employment under this
Agreement is terminated pursuant to Sections&nbsp;4.7(a), (b), (d), (e), or (f), then Employer shall (i)&nbsp;pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.7 at the rate in effect at such termination date,
(ii)&nbsp;pay any amounts as may be due under Sections 5.8, 5.11 and 5.14, and (iii)&nbsp;continue to pay Employee&#146;s Base Salary for a period of eighteen (18)&nbsp;months after the termination date. If this Agreement is terminated pursuant to
Section&nbsp;4.7(c), then Employer shall (i)&nbsp;pay Employee&#146;s Base Salary through the termination date specified in Section&nbsp;4.7 at the rate in effect at such termination date, (ii)&nbsp;pay any amounts as may be due under Sections 5.8,
5.11 and 5.14, and (iii)&nbsp;continue to pay Employee&#146;s Base Salary for a period of twenty-four (24)&nbsp;months after the termination date. <B></B> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.8. <I>Expense Reimbursement. </I>Employee shall be entitled to reimbursement for reasonable business expenses incurred prior to the
termination date, subject, however to the provisions of Section&nbsp;3.1. Such reimbursement shall be made at the times and in accordance with Employer&#146;s normal procedures for reimbursements. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.9. <I>Continuation of Benefit Plans</I>. Employee shall be entitled to continuation of health, medical, hospitalization and other similar
health insurance programs on the same basis as regular, full-time employees of Employer and their eligible dependents during the period that Employee is receiving Base Salary payments under Section&nbsp;5 of this Agreement and, in all cases, as
provided by any applicable law. Following such period of continued benefit plan coverage, Employee and each of his eligible dependents shall be entitled to elect for continuation of coverage provided pursuant to Section&nbsp;601 et. seq. of the
Employee Retirement Income Security Act of 1974, 29 USC &#167;1101 (&#147;COBRA&#148;). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.10 <I>Period for Exercising Stock Options After
Termination. </I>Except as to incentive stock options granted in accordance with Section&nbsp;422 of the Internal Revenue Code, after termination of Employee&#146;s employment under this Agreement for any reason other than pursuant to
Section&nbsp;4.1, Employee shall be allowed a period of twelve months during which to exercise any vested options to purchase MEDNAX, Inc.&#146;s common stock or vested stock appreciation rights and realize any other vested Equity Awards that may be
granted or made under any Equity Plan; provided, however, that in no event shall the period during which Employee may exercise any vested stock option or vested stock appreciation right be extended pursuant to this Section&nbsp;5.10 to a date that
is later than the earlier of (i)&nbsp;the latest date upon which the stock right could have expired by its original terms under any circumstances or (ii)&nbsp;the tenth (10<SUP STYLE="font-size:85%; vertical-align:top">th</SUP>) anniversary of the
original date of grant of the stock right. In all other respects, the terms of the applicable Equity Plan shall control the terms and conditions of any Equity Awards. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.11. <I>Performance Bonus. </I>In the situations described in Sections 5.2, 5.3, 5.4, 5.5 and 5.7, upon termination of this Agreement,
Employee<B> </B>will be paid, solely in consideration of services rendered by Employee prior to termination, a bonus with respect to Employer&#146;s fiscal year in which the termination date occurs, equal to the Performance Bonus, if any, that would
have </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">8 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
been payable to Employee, based on Employee and Employer meeting certain goals and objectives, for the fiscal year if Employee&#146;s employment had not been terminated, multiplied by the number
of days in the fiscal year prior to and including the date of termination and divided by three hundred sixty five (365). The amount of the Post-Termination Performance Bonus paid in the situations described in Sections 5.2, 5.3, 5.4 5.5 and 5.7
shall be determined in good faith by Employer in its sole discretion at the time that Employer distributes bonuses to similarly situated employees. Any amount payable under this Section&nbsp;5.11 shall be paid to Employee when Employer pays
performance bonuses to its eligible employees, which shall be in the calendar year following the termination date of this Agreement. In addition, in the situations described in Section&nbsp;5.7, Employee will be paid, solely in consideration of
services rendered by Employee prior to termination, an additional bonus with respect to Employer&#146;s fiscal year in which the termination date occurs, equal to 1.5x the greater of Employee&#146;s Average Annual Performance Bonus (as defined in
Section&nbsp;5.4) or Employee&#146;s bonus for the year immediately preceding Employee&#146;s termination. Such additional bonus shall be payable to Employee within ninety (90)&nbsp;days of Employee&#146;s termination date pursuant to
Section&nbsp;4.7. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.12. <I>Section</I> <I>409A Compliance</I>. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(a) General.<B> </B>It is the intention of both Employer and Employee that the benefits and rights to which Employee could be
entitled in connection with termination of employment comply with Section&nbsp;409A of the Code and the Treasury Regulations and other guidance promulgated or issued thereunder (&#147;Section&nbsp;409A&#148;), and the provisions of this Agreement
shall be construed in a manner consistent with that intention. If Employee or Employer believes, at any time, that any such benefit or right does not so comply, it shall promptly advise the other and shall negotiate reasonably and in good faith to
amend the terms of such benefits and rights such that they comply with Section&nbsp;409A of the Code (with the most limited possible economic effect on Employee and on Employer). </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(b) Distributions on Account of Separation from Service.<B> </B>If and to the extent required to comply with Section&nbsp;409A,
no payment or benefit required to be paid under this Agreement on account of termination of Employee&#146;s employment shall be made unless and until Employee incurs a &#147;separation from service&#148;, within the meaning of Section&nbsp;409A.
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; font-size:10pt; font-family:Times New Roman">(c) 6 Month Delay for Specified Employees. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; font-size:10pt; font-family:Times New Roman">(i) If Employee is a &#147;specified employee&#148;, then no payment or benefit that is payable on account of Employee&#146;s &#147;separation
from service&#148;, as that term is defined for purposes of Section&nbsp;409A, shall be made before the date that is six months after Employee&#146;s &#147;separation from service&#148; (or, if earlier, the date of Employee&#146;s death) if and to
the extent that such payment or benefit constitutes deferred compensation (or may be nonqualified deferred compensation) under Section&nbsp;409A and such deferral is required to comply with the requirements of Section&nbsp;409A. Any payment or
benefit delayed by reason of the prior sentence shall be paid out or provided in a single lump sum at the end of such required delay period in order to catch up to the original payment schedule. </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) For purposes of this provision, Employee shall be considered to be a
&#147;specified employee&#148; if, at the time of his or her separation from service, Employee is a &#147;key employee&#148;, within the meaning of Section&nbsp;416(i) of the Code, of Employer (or any person or entity with whom Employer would be
considered a single employer under Section&nbsp;414(b) or Section&nbsp;414(c) of the Code) any stock in which is publicly traded on an established securities market or otherwise. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) Unless otherwise required to comply with Section&nbsp;409A, a payment or benefit shall not be deferred pursuant to this
provision if: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:13%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(x) it is not made on account of Employee&#146;s &#147;separation from service&#148;, (y) it is required to
be paid no later than within 2 <SUP STYLE="vertical-align:top">1</SUP>&#8260;<SUB STYLE="vertical-align:bottom">2</SUB> months after the end of the taxable year of Employee in which the payment or benefit is no longer subject to a &#147;substantial
risk of forfeiture&#148;, as that term is defined for purposes of Section&nbsp;409A, or (z)&nbsp;the payment satisfies the following requirements: (A)&nbsp;it is being paid or provided due to Employer&#146;s termination of Employee&#146;s employment
without Cause (Section 4.4) or Employee&#146;s termination of employment after a Change in Control for the reasons set forth in Section&nbsp;4.7 hereof, (B)&nbsp;it does not exceed two times the lesser of (1)&nbsp;Employee&#146;s annualized
compensation from Employer for the calendar year prior to the calendar year in which the termination of Employee&#146;s employment occurs, and (2)&nbsp;the maximum amount of compensation that may be taken into account under a qualified plan pursuant
to Section&nbsp;401(a)(17) of the Code for the year in which Employee&#146;s employment terminates, and (C)&nbsp;the payment is required under this Agreement to be paid no later than the last day of the second calendar year following the calendar
year in which Employee incurs a &#147;separation from service&#148;. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(d) No Acceleration of Payments. Neither Employer nor
Employee, individually or in combination, may accelerate any payment or benefit that is subject to Section&nbsp;409A, except in compliance with Section&nbsp;409A and the provisions of this Agreement, and no amount shall be paid prior to the earliest
date on which it may be paid without violating Section&nbsp;409A. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(e) Treatment of Each Installment as a Separate Payment.
For purposes of applying the provisions of Section&nbsp;409A to this Agreement, each separately identified amount to which Employee is entitled under this Agreement shall be treated as a separate payment. In addition, to the extent permissible under
Section&nbsp;409A, any series of installment payments under this Agreement shall be treated as a right to a series of separate payments. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(f) Reimbursements and <FONT STYLE="white-space:nowrap">In-Kind</FONT> Benefits. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) Any reimbursements by Employer to Employee of any eligible expenses pursuant to Section&nbsp;3.1 or 5.8 of this Agreement,
that are not excludible from Employee&#146;s income for Federal income tax purposes (&#147;Taxable Reimbursements&#148;) shall be made on or before the last day of the taxable year of Employee following the year in which the expense was incurred.
</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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) The amount of any Taxable Reimbursements, and the value of any <FONT
STYLE="white-space:nowrap">in-kind</FONT> benefits to be provided to Employee under this Agreement, during any taxable year of Employee shall not affect the expenses eligible for reimbursement, or <FONT STYLE="white-space:nowrap">in-kind</FONT>
benefits to be provided, in any other taxable year of Employee. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(iii) The right to Taxable Reimbursements, or <FONT
STYLE="white-space:nowrap">in-kind</FONT> benefits, shall not be subject to liquidation or exchange for another benefit. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.13.
<I>Release. </I>Employer shall provide Employee with a general release in the form attached as Exhibit C (subject to such modifications as Employer may reasonably request) within seven (7)&nbsp;days after Employee&#146;s termination
date.&nbsp;Payments or benefits to which Employee may be entitled pursuant to this Section&nbsp;5 (other than any accrued but unpaid Base Salary and employee benefits as of the end of the Employment Period) (the &#147;Severance Amounts&#148;) shall
be conditioned upon Employee executing the general release within 21 days after receiving it from Employer and the general release becoming irrevocable upon the expiration of 7 days following the Employee&#146;s execution of it. Payment of the
Severance Amounts shall be suspended during the period (the &#147;Suspension Period&#148;) that begins on Employee&#146;s termination date and ends on the date (&#147;Suspension Termination Date&#148;) that is thirty-five (35)&nbsp;days after
Employee&#146;s termination date; provided, however, that this suspension shall not apply, and Employer shall be required to provide, any continued health insurance coverage that would be required under Section&nbsp;5.9 hereof during the Suspension
Period. If Employee executes the general release and the general release becomes irrevocable by no later than the Suspension Termination Date, then payment of any Severance Amounts that were suspended pursuant to this provision shall be made in the
first payroll period that follows the Suspension Termination Date, and any Severance Amounts that are payable after the Suspension Termination Date shall be paid at the times provided in Section&nbsp;5. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">5.14. <I>Vesting of Incentive Awards. </I>Notwithstanding any contrary provision in this Agreement or<B> </B>any Equity Plan then maintained
by MEDNAX, Inc.: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(a) all Equity Awards granted to Employee by MEDNAX, Inc. prior to termination of this Agreement shall continue to vest
until fully vested following a termination of Employee&#146;s employment pursuant to Section&nbsp;4.2, 4.3, and 4.5, and, following a termination of Employee&#146;s employment pursuant to Sections 4.4 or 4.7 shall become fully vested, <FONT
STYLE="white-space:nowrap">non-forfeitable,</FONT> and if applicable, exercisable;<B> </B>and </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">(b) in the event of a Change in Control
after the date of this Agreement: </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(i) if, prior to the one (1)&nbsp;year anniversary of the effective date of such Change
in Control, the employment by MEDNAX, Inc. or its affiliates or successors of both Roger J. Medel, M.D. and Joseph M. Calabro is terminated for any reason, or they both no longer hold the positions they held just prior to the Change in Control (and
neither holds the top executive position in the company), then the Equity Awards granted to the Employee that are outstanding (the &#147;Accelerated Awards&#148;) shall become fully vested and payable to the Employee on
</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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:8%; font-size:10pt; font-family:Times New Roman">
the first anniversary of the effective date of such Change in Control; provided, however, that any portion of the Accelerated Awards that is scheduled to become vested and payable pursuant to its
terms prior to the first anniversary of such Change in Control shall become vested and payable to the Employee pursuant to its terms; and </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:8%; text-indent:4%; font-size:10pt; font-family:Times New Roman">(ii) if, after the one (1)&nbsp;year anniversary of the effective date of such Change in Control, the employment by MEDNAX,
Inc. or its affiliates or successors of both Roger J. Medel, M.D. and Joseph M. Calabro is terminated for any reason, or they both no longer hold the positions they held just prior to the Change in Control (provided that neither holds the top
executive position in the company), then the Accelerated Awards shall become fully vested and payable to the Employee on the one (1)&nbsp;year anniversary of the termination date, or date of the change in position of Roger J. Medel, M.D. or Joseph
M. Calabro, whichever termination date or date in change of position is later; provided, however, that any portion of the Accelerated Awards that is scheduled to become vested and payable pursuant to its terms prior to the one (1)&nbsp;year
anniversary of such termination date or date of change in position shall become vested and payable to the Employee pursuant to its terms; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">provided in the
case of both clauses (i)&nbsp;and (ii) above, that the Employee remains in Continuous Service (as defined in the applicable Equity Plan) from the date of this Agreement through the date on which such Accelerated Awards would vest pursuant to clauses
(i)&nbsp;or (ii) above, as applicable. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Notwithstanding anything to the contrary in this Agreement, the Equity Plans or the Equity Awards,
in the event of a Change in Control immediately following which neither the common stock of MEDNAX, Inc. nor the common equity of its successor, parent or subsidiary is listed for trading on a national securities exchange (a &#147;Going Private
Transaction&#148;), then all unvested Equity Awards granted to the Employee shall be adjusted so that in lieu of the Employee&#146;s right to receive shares of common stock of MEDNAX, Inc. pursuant to the terms of such Equity Awards, the Employee
shall be entitled to receive, for each share of common stock of MEDNAX, Inc. that Employee would otherwise be entitled to receive pursuant to such Equity Awards, an amount of cash equal to the amount per share of common stock of MEDNAX, Inc. paid to
the shareholders of MEDNAX, Inc. in such Going Private Transaction, as determined by the Compensation Committee of the Board in its sole discretion, in each case consistent with the vesting schedule of such Equity Awards and shall remain subject to
the acceleration provisions set forth in this Section&nbsp;5.14. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>6. Successors; Binding Agreement. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">6.1. <I>Successors</I>. Employer shall require any successor (whether direct or indirect, by purchase, merger, consolidation or otherwise)
acquiring a majority of Employer&#146;s voting common stock or any other successor to all or substantially all of the business and/or assets of Employer to expressly assume and agree to perform this Agreement in the same manner and to the same
extent that Employer would be required to perform it if no such succession had taken place and Employee hereby consents to any such assignment. In such event, &#147;Employer&#148; shall </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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
mean Employer as previously defined and any successor to its business and/or assets which executes and delivers the agreement provided for in this Section&nbsp;6 or which otherwise becomes bound
by all the terms and provisions of this Agreement by operation of law. This Section shall not limit Employee&#146;s ability to terminate this Agreement in the circumstances described in Section&nbsp;4.7 in the event of a Change in Control. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">6.2. <I>Benefit</I>. This Agreement and all rights of Employee under this Agreement shall inure to the benefit of and be enforceable by
Employee&#146;s personal or legal representatives, executors, administrators, successors, heirs, distributees, devisees and legatees. If Employee should die after the termination date and amounts would have been payable to Employee under this
Agreement if Employee had continued to live, including under Section&nbsp;5 hereof, then such amounts shall be paid to Employee&#146;s devisee, legatee, or other designee or, if there is no such designee, Employee&#146;s estate. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>7.</B> <B>Conflicts with Prior Employment Contract. </B>This Agreement constitutes the entire agreement among the parties pertaining to the
subject matter hereof, and supersedes and revokes any and all prior or existing agreements, written or oral, relating to the subject matter hereof, and this Agreement shall be solely determinative of the subject matter hereof. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>8. Restrictive Covenants; Confidential Information; Work Product; Injunctive Relief. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.1. <I>No Material Competition</I>. Employer and Employee acknowledge and agree that a strong relationship and connection exists between
Employer and its current and prospective patients, referral sources, and customers as well as the hospitals and healthcare facilities at which it provides professional services. Employer and Employee further acknowledge and agree that the
restrictive covenants described in this Section are designed to enforce, and are ancillary to or part of, the promises contained in this Agreement and are reasonably necessary to protect the legitimate interests of Employer in the following:
(1)&nbsp;the use and disclosure of the Confidential Information as described in Section&nbsp;8.4; (2) the professional development activities described in Section&nbsp;1.2; and (3)&nbsp;the goodwill of the Employer, as promoted by Employee as
provided in Section&nbsp;1.2. The foregoing listing is by way of example only and shall not be construed to be an exclusive or exhaustive list of such interests. Employee acknowledges that the restrictive covenants set forth below are of significant
value to Employer and were a material inducement to Employer in agreeing to the terms of this Agreement. Employee further acknowledges that the goodwill and other proprietary interest of Employer will suffer irreparable and continuing damage in the
event Employee enters into competition with Employer in violation of this Section. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Therefore, Employee agrees that, except with respect to services
performed under this Agreement on behalf of Employer, <B>Employee shall not</B>, at any time during the Restricted Period (as defined below), for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer,
participate or engage in or own an interest in, directly or indirectly, any individual proprietorship, partnership, corporation, joint venture, trust or other form of business entity, whether as an individual proprietor, partner, joint venturer,
officer, director, member, employee, consultant, independent contractor, stockholder, lender, landlord, finder, agent, broker, trustee, or in any manner whatsoever, if such entity or its affiliates is engaged in, directly or indirectly,
</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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
&#147;Employer&#146;s Business,&#148; as defined on Exhibit A hereto. Employee acknowledges that, as of the date hereof, Employee&#146;s responsibilities will include matters affecting the
businesses of Employer listed on Exhibit A. For purposes of this Section&nbsp;8, the &#147;Restricted Period&#148; shall mean the Employment Period plus (i)&nbsp;eighteen (18) months in the event this Agreement is terminated pursuant to Sections
4.1, (ii) thirty (30)&nbsp;months in the event the Agreement is terminated pursuant to Section&nbsp;4.4; (iii) thirty (30)&nbsp;months in the event the Agreement is terminated pursuant to Section&nbsp;4.7 following a Change in Control, and
(iii)&nbsp;twenty-four (24)&nbsp;months in the event the Agreement is terminated for any other reason. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.2. <I>No Hire</I>. Employee
further agrees that <B>Employee shall not</B>, at any time during the Employment Period and for a period of eighteen (18)&nbsp;months immediately following termination of this Agreement for any reason, for Employee or on behalf of any other person,
persons, firm, partnership, corporation or employer, intentionally, knowingly, or willingly employ, or intentionally, knowingly, or willingly permit any company or business directly or indirectly controlled by Employee to employ or otherwise engage
(a)&nbsp;any person who is a then current employee or independent contractor of Employer or one of its affiliates, or (b)&nbsp;any person who was an employee or independent contractor of Employer or one of its affiliates in the prior six
(6)&nbsp;month period, or in any manner seek to induce such persons to leave his or her employment or engagement with Employer or one of its affiliates (including without limitation for or on behalf of a subsequent employer of Employee). </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.3 <I><FONT STYLE="white-space:nowrap">Non-solicitation.</FONT> </I>Employee further agrees that <B>Employee shall not</B>, at any time
during the Employment Period and for a period of eighteen (18)&nbsp;months immediately following termination of this Agreement for any reason, for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer,
solicit or accept business from or take any action that would interfere with, diminish or impair the valuable relationships that Employer or its affiliates have with (i)&nbsp;hospitals or other health care facilities with which Employer or its
affiliates have contracts to render professional services or otherwise have established relationships, (ii)&nbsp;patients, (iii) referral sources, (iv)&nbsp;vendors, (v) any other clients of Employer or its affiliates, or (vi)&nbsp;prospective
hospitals, patients, referral sources, vendors or clients whose business Employee was aware that Employer or any affiliate of Employer was in the process of soliciting at the time of Employee&#146;s termination (including potential acquisition
targets). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.4. <I>Confidential Information</I>. At all times during the term of this Agreement, Employer shall provide Employee with
access to &#147;Confidential Information.&#148; As used in this Agreement, the term &#147;Confidential Information&#148; means any and all confidential, proprietary or trade secret information, whether disclosed, directly or indirectly, verbally, in
writing or by any other means in tangible or intangible form, including that which is conceived or developed by Employee, applicable to or in any way related to: (i)&nbsp;patients with whom Employer has a physician/patient relationship;
(ii)&nbsp;the present or future business of Employer; or (iii)&nbsp;the research and development of Employer. Without limiting the generality of the foregoing, Confidential Information includes: (a)&nbsp;the development and operation of
Employer&#146;s medical practices, including information relating to budgeting, staffing needs, marketing, research, hospital relationships, equipment capabilities, and other information concerning such facilities and operations and specifically
including the procedures and business plans developed by Employer for use at the hospitals where Employer conducts its business; (b)&nbsp;contractual arrangements </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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
between the Employer and insurers or managed care associations or other payors; (c)&nbsp;the databases of Employer; (d)&nbsp;the clinical and research protocols of Employer, including coding
guidelines; (e)&nbsp;the referral sources of Employer; (f)&nbsp;other confidential information of Employer that is not generally known to the public that gives Employer the opportunity to obtain an advantage over competitors who do not know or use
it, including the names, addresses, telephone numbers or special needs of any of its patients, its patient lists, its marketing methods and related data, lists or other written records used in Employer&#146;s business, compensation paid to employees
and other terms of employment, accounting ledgers and financial statements, contracts and licenses, business systems, business plan and projections, and computer programs. The parties agree that, as between them, this Confidential Information
constitutes important, material, and confidential trade secrets that affect the successful conduct of Employer&#146;s business and its goodwill. Employer acknowledges that the Confidential Information specifically enumerated above is special and
unique information and is not information that would be considered a part of the general knowledge and skill Employee has or might otherwise obtain. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Notwithstanding the foregoing, Confidential Information shall not include any information that (i)&nbsp;was known by Employee from a third
party source before disclosure by or on behalf of Employer, (ii)&nbsp;becomes available to Employee from a source other than Employer that is not, to Employee&#146;s knowledge, bound by a duty of confidentiality to Employer, (iii)&nbsp;becomes
generally available or known in the industry other than as a result of its disclosure by Employee, or (iv)&nbsp;has been independently developed by Employee and may be disclosed by Employee without breach of this Agreement, provided, in each case,
that the Employee shall bear the burden of demonstrating that the information falls under one of the above-described exceptions. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Employee
agrees that the terms of this Agreement shall be deemed Confidential Information for purposes of this Section. Employee shall keep the terms of this Agreement strictly confidential and will not, without the prior written consent of Employer,
disclose the details of this Agreement to any third party in any manner whatsoever in whole or in part, with the exception of Employee&#146;s representatives (such as tax advisors and attorneys) who need to know such information. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">Employee agrees that Employee will not at any time, whether during or subsequent to the term of Employee&#146;s employment with Employer, in
any fashion, form or manner, unless specifically consented to in writing by Employer, either directly or indirectly, use or divulge, disclose, or communicate to any person, firm or corporation, in any manner whatsoever, any Confidential Information
of any kind, nature, or description, subject to applicable law. The parties agree that any breach by Employee of any term of this Section is a material breach of this Agreement and shall constitute &#147;cause&#148; for the termination of
Employee&#146;s employment hereunder. In the event that Employee is ordered to disclose any Confidential Information, whether in a legal or a regulatory proceeding or otherwise, Employee shall provide Employer with prompt written notice of such
request or order so that Employer may seek to prevent disclosure or, if that cannot be achieved, the entry of a protective order or other appropriate protective device or procedure in order to assure, to the extent practicable, compliance with the
provisions of this Agreement. In the case of any disclosure required by law, Employee shall disclose only that portion of the Confidential Information that Employee is ordered to disclose in a legally binding subpoena, demand or similar order issued
pursuant to a legal or regulatory proceeding. </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">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">All Confidential Information, and all equipment, notebooks, documents, memoranda, reports,
files, samples, books, correspondence, lists, other written and graphic records, in any media (including electronic or video) containing Confidential Information or relating to the business of Employer, which Employee shall prepare, use, construct,
observe, possess, or control shall be and remain Employer&#146;s sole property (collectively &#147;Employer Property&#148;). Upon termination or expiration of this Agreement, or earlier upon Employer&#146;s request, Employee shall promptly deliver
to Employer all Employer Property, retaining none. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.5. <I>Ownership of Work Product.</I> Employee agrees and acknowledges that
(i)&nbsp;all copyrights, patents, trade secrets, trademarks, service marks, or other intellectual property or proprietary rights associated with any ideas, concepts, techniques, inventions, processes, or works of authorship developed or created by
Employee during the course of performing work for Employer and any other work product conceived, created, designed, developed or contributed by Employee during the term of this Agreement that relates in any way to Employer&#146;s Business
(collectively, the &#147;Work Product&#148;), shall belong exclusively to Employer and shall, to the extent possible, be considered a work made for hire within the meaning of Title 17 of the United States Code. To the extent the Work Product may not
be considered a work made for hire owned exclusively by Employer, Employee hereby assigns to Employer all right, title, and interest worldwide in and to such Work Product at the time of its creation, without any requirement of further consideration.
Upon request of Employer, Employee shall take such further actions and execute such further documents as Employer may deem necessary or desirable to further the purposes of this Agreement, including without limitation separate assignments of all
right, title, and interest in and to all rights of copyright and all right, title, and interest in and to any inventions or patents and any reissues or extensions which may be granted therefore, and in and to any improvements, additions to, or
modifications thereto, which Employee may acquire by invention or otherwise, the same to be held and enjoyed by Employer for its own use and benefit, and for the use and benefit of Employer&#146;s successors and assigns, as fully and as entirely as
the same might be held by Employee had this assignment not been made. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.6. <I>Clearance Procedure for Proprietary Rights Not Claimed by
Employer.</I> In the event that Employee wishes to create or develop, <I>other than</I> on Employer&#146;s time or using Employer&#146;s resources, anything that may be considered Work Product but to which Employee believes Employee should be
entitled to the personal benefit of, Employee agrees to follow the clearance procedure set forth in this Section. Before beginning any such work, Employee agrees to give Employer advance written notice and provide Employer with a sufficiently
detailed written description of the work under consideration for Employer to make a determination regarding the work. Unless otherwise agreed in a writing signed by Employer prior to receipt, Employer shall have no obligation of confidentiality with
respect to such request or description. Employer will determine in its sole discretion, within thirty (30)&nbsp;days after Employee has fully disclosed such plans to Employer, whether rights in such work will be claimed by Employer. If Employer
determines that it does not claim rights in such work, Employer agrees to so notify Employee in writing and Employee may retain ownership of the work to the extent that such work has been expressly disclosed to Employer. If Employer fails to so
notify Employee within such thirty (30)&nbsp;day period, then Employer shall be deemed to have agreed that such work is not considered Work Product for purposes of this Agreement. Employee agrees to submit for further review any significant
improvement, modification, or adaptation that could reasonably be related to Employer&#146;s Business so that it can be determined whether the improvement, modification, or adaptation relates to the business or interests of Employer. Clearance under
this procedure does not relieve Employee of the restrictive covenants set forth in this Section&nbsp;8. </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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.7. <I><FONT STYLE="white-space:nowrap">Non-Disparagement.</FONT></I> For a period of ten
(10)&nbsp;years after the termination of this Agreement, Employee will not, directly or indirectly, as an individual or on behalf of a firm, corporation, partnership or other legal entity, make any disparaging or negative comment to any other person
or entity regarding Employer or any of its affiliates, agents, attorneys, employees, officers and directors, Employee&#146;s work conditions or circumstances surrounding Employee&#146;s separation from Employer or otherwise impugn or criticize the
name or reputation of Employer, its affiliates, agents, attorneys, employees, officers or directors, orally or in writing. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.8. <I>Review
by Employee.</I> <B>Employee has carefully read and considered the terms and provisions of this Section</B><B></B><B>&nbsp;8, and having done so, agrees that the restrictions set forth in this Section</B><B></B><B>&nbsp;8 are fair and reasonably
required for the protection of the interests of Employer.</B> In the event that any term or provision set forth in this Section&nbsp;8 shall be held to be invalid or unenforceable by a court of competent jurisdiction, the parties hereto agree that
such invalid or unenforceable term(s) or provision(s) may be severed from this Agreement without, in any manner, affecting the remaining portions hereof. Without limiting other possible remedies available to Employer, Employee agrees that injunctive
or other equitable relief will be available to enforce the covenants set forth in this Section, such relief to be without the necessity of posting a bond. In the event that, notwithstanding the foregoing, any part of the covenants set forth in this
Section shall be held to be invalid, overbroad, or unenforceable by an arbitration panel or a court of competent jurisdiction, the parties hereto agree that such invalid, overbroad, or unenforceable provision(s) may be modified or severed from this
Agreement without, in any manner, affecting the remaining portions of this Section&nbsp;8 (all of which shall remain in full force and effect). In the event that any provision of this Section&nbsp;8 related to time period or areas of restriction
shall be declared by an arbitration panel or a court of competent jurisdiction to exceed the maximum time period, area or activities such arbitration panel or court deems reasonable and enforceable, said time period or areas of restriction shall be
deemed modified to the minimum extent necessary to make the geographic or temporal restrictions or activities reasonable and enforceable. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:8%; font-size:10pt; font-family:Times New Roman">8.9. <I>Survival.</I> The provisions of this Section&nbsp;8 shall survive the termination of this Agreement and Employee&#146;s employment
with Employer.<B> </B>The provisions of this Section&nbsp;8 shall apply during the time Employee is receiving Disability payments from Employer as a result of a termination of this Agreement pursuant to Section&nbsp;4.2 hereof.<B> </B>In the event
of a breach of this Section&nbsp;8 by Employee, Employer retains the right to terminate any continuing payments to Employee provided for in Section&nbsp;5 of this Agreement. The provisions of this Section&nbsp;8 are expressly intended to benefit and
be enforceable by other affiliated entities of Employer, who are express third party beneficiaries hereof. Employee shall not assist others in engaging in any of the activities described in the foregoing restrictive covenants. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>9. </B><B>Arbitration. </B>Any controversy or claim arising out of or relating to this Agreement, or any alleged breach hereof shall be
finally determined by a single arbitrator, jointly selected by the Employee and Employer, provided that if Employee and Employer are unable to agree upon a single arbitrator after reasonable efforts, the arbitrator shall be an impartial arbitrator
selected by </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">17 </P>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
the American Arbitration Association. Each party hereto shall share equally the costs of the arbitrator, and the parties agree that the costs of arbitration shall not be subject to
reapportionment by the arbitrator; <U>provided, however</U>, that if following a termination of Employee&#146;s employment that follows a Change in Control or if following a termination of Employee&#146;s employment for Good Reason that follows any
person other than Roger J. Medel or Joseph M. Calabro commencing service as the senior most executive officer of Mednax, Employee seeks arbitration to enforce the terms of this Agreement, Employer shall bear all costs associated with such
arbitration, including but not limited to all costs of the arbitrator, and shall reimburse Employee on a monthly basis for his reasonable legal and other expenses, including all fees, incurred in connection with any such arbitration. The arbitration
proceedings shall be held in Sunrise, Florida, unless otherwise mutually agreed by the parties, and shall be conducted in accordance with the American Arbitration Association National Rules for the Resolution of Employment Disputes then in effect.
Judgment on the award rendered by the arbitration panel may be entered and enforced by any court having jurisdiction thereof. Any such arbitration shall be treated as confidential by all parties thereto, except as otherwise provided by law or as
otherwise necessary to enforce any judgment or order issued by the arbitrators. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding anything herein to the contrary, if
Employer or Employee shall require immediate injunctive relief, then the party shall be entitled to seek such relief in any court having jurisdiction, and if the party elects to do so, the other party hereby consents to the jurisdiction of the state
and federal courts sitting in the State of Florida and to the applicable service of process. Employee and Employer hereby waive and agree not to assert, to the fullest extent permitted by applicable law, any claim that (i)&nbsp;they are not subject
to the jurisdiction of such courts, (ii)&nbsp;they are immune from any legal process issued by such courts and (iii)&nbsp;any litigation or other proceeding commenced in such courts is brought in an inconvenient forum. In the event that either party
hereto brings suit seeking injunctive relief, the party found to be at fault shall pay all reasonable court costs and attorneys&#146; fees of the other, whether such costs and fees are incurred in a court of original jurisdiction or one or more
courts of appellate jurisdiction. Notwithstanding the foregoing, in the event that Employer brings suit against Employee seeking injunctive relief, Employer agrees to advance all of Employee&#146;s reasonable legal and other expenses, including all
fees, incurred by the Employee in connection with such action, provided, however, that if Employer ultimately prevails in seeking injunctive relief, Employee shall reimburse Employer all such advanced legal fees and other expenses. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>10.</B> <B>Governing Law.</B> This Agreement shall be governed by and construed in accordance with the laws of the State of Florida without
regard to its conflict of laws principles to the extent that such principles would require the application of laws other than the laws of the State of Florida. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>11.</B> <B>Notices.</B> Any notice required or permitted to be given under this Agreement shall be in writing and shall be deemed to have
been given when delivered by hand or when deposited in the United States mail by registered or certified mail, return receipt requested, postage prepaid, addressed as follows: </P>
 <p STYLE="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>

</DIV></Center>


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


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

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


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; font-size:10pt; font-family:Times New Roman">If to Employer:</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">If to Employee:</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:4.00em; font-size:10pt; font-family:Times New Roman">Mednax Services, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">David A. Clark</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:4.00em; font-size:10pt; font-family:Times New Roman">1301 Concord Terrace</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">1301 Concord Terrace</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:4.00em; font-size:10pt; font-family:Times New Roman">Sunrise, FL 33323</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top">Sunrise, FL 33323</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:4.00em; font-size:10pt; font-family:Times New Roman">Attention: General Counsel</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"></TD></TR>
</TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">or to such other addresses as either party hereto may from time to time give notice of to the other in the aforesaid manner.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>12.</B> <B>Benefits: Binding Effect.</B> This Agreement shall be for the benefit of and binding upon the parties hereto and their
respective heirs, personal representatives, legal representatives, successors and, where applicable, assigns. Notwithstanding the foregoing, Employee may not assign the rights or benefits hereunder without the prior written consent of Employer. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>13.</B> <B>Severability. </B>The invalidity of any one or more of the words, phrases, sentences, clauses or sections contained in this
Agreement shall not affect the enforceability of the remaining portions of this Agreement or any part thereof, all of which are inserted conditionally on their being valid in law, and, in the event that any one or more of the words, phrases,
sentences, clauses or sections contained in this Agreement shall be declared invalid, this Agreement shall be construed as if such invalid word or words, phrase or phrases, sentence or sentences, clause or clauses, or section or sections had not
been inserted. If such invalidity is caused by length of time or size of area, or both, the otherwise invalid provision will be considered to be reduced to a period or area, which would cure such invalidity. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>14.</B> <B>Waivers. </B>The waiver by either party hereto of a breach or violation of any term or provision of this Agreement shall not
operate nor be construed as a waiver of any subsequent breach or violation. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>15.</B> <B>Damages. </B>Nothing contained herein shall be
construed to prevent Employer or Employee from seeking and recovering from the other damages sustained by either or both of them as a result of a breach of any term or provision of this Agreement. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>16.</B> <B>No Third Party Beneficiary. </B>Except as provided in Section&nbsp;8.9, nothing expressed or implied in this Agreement is
intended, or shall be construed, to confer upon or give any person (other than the parties hereto and, in the case of Employee, Employee&#146;s heirs, personal representative(s) and/or legal representative) any rights or remedies under or by reason
of this Agreement. No agreements or representations, oral or otherwise, express or implied, have been made by either party with respect to the subject matter of this Agreement which agreements or representations are not set forth expressly in this
Agreement, and this Agreement supersedes any other employment agreement between Employer and Employee. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman"><B>17.</B> <B>Assignment.</B> This
Agreement may be assigned by Employer upon notice to Employee. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>The remainder of this page has been left blank intentionally. </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">19 </P>

</DIV></Center>


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


<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"><B>IN WITNESS WHEREOF</B>, the undersigned have executed this Agreement this 12th day of
February, 2019, effective as of the Effective Date. </P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="100%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


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


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

</DIV></Center>


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


<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>EXHIBIT A </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>BUSINESS OF EMPLOYER </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As
of the date hereof, Employer, directly or through its affiliates, provides professional medical services and all aspects of practice management services in medical practice areas that include, but are not limited to, the following (collectively
referred to herein as &#147;Employer&#146;s Business&#148;): </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(1) Neonatology, including hospital well baby care; </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(2) Maternal-Fetal Medicine, including general obstetrics services; </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(3) Pediatric Cardiology; </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(4) Pediatric Intensive Care,
including Pediatric Hospitalist Care; </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(5) Newborn hearing screening services; </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(6) Pediatric Surgery; </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(7) Pediatric Emergency Medicine; </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(8) Anesthesiology, critical care medicine and pain management; and </P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">(9) Radiology and Teleradiology. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">References to
Employer&#146;s Business in this Agreement shall include such other medical service lines, practice management services and other businesses in which Employer is engaged during the Employment Period; <I>provided,</I> that to be considered a part of
Employer&#146;s Business, Employer must have engaged in such other service line, practice management service or other business at least six (6)&nbsp;months prior to the termination date of this Agreement. For purposes of this Exhibit A, businesses
of Employer shall include the businesses conducted by Employer&#146;s subsidiaries, entities under common control and affiliates as defined under Rule 144 of the Securities Act of 1933, as amended. Such affiliates shall include the professional
corporations and associations whose operating results are consolidated with Employer for financial reporting purposes. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Notwithstanding
the foregoing, Employer acknowledges and agrees to the following exceptions and clarifications regarding the scope of Employer&#146;s Business. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">A. <I>Hospital Services. </I>Employer and Employee acknowledge that, as of the date hereof, Employer does not currently operate hospitals,
hospital systems or universities. Nevertheless, the businesses of hospitals, hospital systems and universities would be the same as Employer&#146;s Business where such hospitals, hospital systems or universities provide or contract with others to
provide some or all of the medical services included in Employer&#146;s Business. Therefore, the parties desire to clarify their intent with respect to the limitations on Employee&#146;s ability to work for or contract with others to provide
services for a hospital, hospital system or university during the Employment Period and during the Restricted Period. Section&nbsp;8.1 shall not be deemed to restrict Employee&#146;s ability to work for a hospital, hospital system or university if
the hospital, hospital system or university does not provide any of the medical services included in Employer&#146;s Business. Furthermore, even if a hospital, hospital system or university provides medical services that are included in
Employer&#146;s Business, Employee may work for such hospital, </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>

</DIV></Center>


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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">
hospital system or university if Employee has no direct supervisory responsibility for or involvement in the hospital&#146;s, hospital system&#146;s or university&#146;s medical services that are
Employer&#146;s Business. Finally, Employer agrees that Employee may hold direct supervisory responsibility for or be involved in the medical services of a hospital, hospital system or university that are included in Employer&#146;s Business so long
as such hospital, hospital system or university is located at least ten (10)&nbsp;miles from a medical practice owned or operated by Employer or its affiliate. Subject to paragraph B below, the provisions of this paragraph shall not apply to the
extent that, after the date hereof, Employer enters into the business of operating a hospital or hospital system. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">B. <I>De Minimus
Exception. </I>Employer agrees that a medical service line (other than those listed in items 1 through 9 above), practice management service or other business in which Employer is engaged shall not be considered to be a part of Employer&#146;s
Business if such medical service line, practice management service or other business constitutes less than three percent (3%) of Employer&#146;s annual revenues. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">C. It shall not be deemed to be a violation of Section&nbsp;8.1 for Employee to: (i)&nbsp;own, directly or indirectly, one percent (1%) or
less of a publicly-traded entity that has a market capitalization of $1&nbsp;billion or more; (ii)&nbsp;own, directly or indirectly, five percent (5%) or less of a publicly-traded entity that has a market capitalization of less than $1&nbsp;billion;
or (iii)&nbsp;own, directly or indirectly, less than ten percent (10%) of a privately-held business or company, if Employee is at all times a passive investor with no board representation, management authority or other special rights to control
operations of such business or company.<I> </I> </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>

</DIV></Center>


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


<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>EXHIBIT B </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>COMPENSATION </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Performance Bonus:</B>
Target of One Hundred Percent (100%) of Employee&#146;s Base Salary with a Maximum Bonus potential of Two Hundred Percent (200%) of Employee&#146;s Base Salary </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Equity Compensation: </B>Employee&#146;s annual equity compensation grant target amount shall be at least $1.95&nbsp;million, subject to the approval of
the Compensation Committee of the Board of Directors. </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">23 </P>

</DIV></Center>


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


<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>EXHIBIT C </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>FORM OF RELEASE </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><I>GENERAL RELEASE OF CLAIMS </I></B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">1. _______________ (&#147;<U>Employee</U>&#148;), for himself and his family, heirs, executors, administrators, legal representatives and
their respective successors and assigns, in exchange for the consideration received pursuant to Section&nbsp;5.[ ] of the Employment Agreement to which this release is attached as Exhibit C (the &#147;<U>Employment Agreement</U>&#148;), does hereby
release and forever discharge _____________________ (&#147;<U>Employer</U>&#148;), its subsidiaries, affiliated companies, successors and assigns, and its current or former directors, officers, employees, shareholders or agents in such capacities
(collectively with Employer, the &#147;<U>Released Parties</U>&#148;) from any and all actions, causes of action, suits, controversies, claims and demands whatsoever, for or by reason of any matter, cause or thing whatsoever, whether known or
unknown including, but not limited to, all claims under any applicable laws arising under or in connection with Employee&#146;s employment or termination thereof, whether for discrimination, harassment, retaliation, tort, breach of express or
implied employment contract, wrongful discharge, intentional infliction of emotional distress, or defamation or injuries incurred on the job or incurred as a result of loss of employment. Employee acknowledges that Employer encouraged him to consult
with an attorney of his choosing, and through this General Release of Claims encourages Employee to consult with his attorney with respect to possible claims under the Age Discrimination in Employment Act (&#147;<U>ADEA</U>&#148;) and that he
understands that the ADEA is a Federal statute that, among other things, prohibits discrimination on the basis of age in employment and employee benefits and benefit plans. Without limiting the generality of the release provided above, Employee
expressly waives any and all claims under ADEA that he may have as of the date hereof. Employee further understands that by signing this General Release of Claims he is in fact waiving, releasing and forever giving up any claim under the ADEA as
well as all other laws within the scope of this paragraph 1 that may have existed on or prior to the date hereof. Notwithstanding anything in this paragraph 1 to the contrary, this General Release of Claims shall not apply to (i)&nbsp;any actions to
enforce rights to receive any payments or benefits which may be due Employee pursuant to Section&nbsp;5.[ ] of the Employment Agreement, or under any of Employer&#146;s employee benefit plans, (ii)&nbsp;any rights or claims that may arise as a
result of events occurring after the date this General Release of Claims is executed, (iii)&nbsp;any indemnification rights Employee may have as a former officer or director of Employer or its subsidiaries or affiliated companies, (iv)&nbsp;any
claims for benefits under any directors&#146; and officers&#146; liability policy maintained by Employer or its subsidiaries or affiliated companies in accordance with the terms of such policy, and (v)&nbsp;any rights as a holder of equity
securities of Employer. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">2. Employee represents that he has not filed against the Released Parties any complaints, charges, or lawsuits
arising out of his employment, or any other matter arising on or prior to the date of this General Release of Claims, and covenants and agrees that he will never individually or with any person file, or commence the filing of, any charges, lawsuits,
complaints or proceedings with any governmental agency, or against the Released Parties with respect to any of the matters released by Employee pursuant to paragraph 1 hereof (a &#147;<U>Proceeding</U>&#148;). </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">24 </P>

</DIV></Center>


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


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


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


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" STYLE="BORDER-BOTTOM:1px solid #000000"> &nbsp;<P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:3pt">&nbsp;</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"> <P STYLE="font-size:18pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman">_______________, 20__</P></TD></TR>
</TABLE></DIV>
 <p STYLE="margin-top:0pt;margin-bottom:0pt ; font-size:8pt">&nbsp;</P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center">25 </P>

</DIV></Center>

</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-21.1
<SEQUENCE>6
<FILENAME>d671465dex211.htm
<DESCRIPTION>EX-21.1
<TEXT>
<HTML><HEAD>
<TITLE>EX-21.1</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 21.1 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Subsidiaries </B></P> <P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="92%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" ALIGN="center">


<TR>
<TD WIDTH="57%"></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" ROWSPAN="2" NOWRAP><B>Name of Subsidiary</B></TD>
<TD VALIGN="bottom" ROWSPAN="2">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ROWSPAN="2" ALIGN="center"><B>State of<BR>Incorporation</B></TD>
<TD VALIGN="bottom" ROWSPAN="2">&nbsp;</TD>
<TD VALIGN="bottom" ROWSPAN="2">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ROWSPAN="2" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>Line of</B></P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>Business</B></P></TD>
<TD VALIGN="bottom" ROWSPAN="2">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="6" ALIGN="center"><B>Number&nbsp;of&nbsp;Omitted<BR>Subsidiaries&nbsp;Operating</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center"><B>in the<BR>United<BR>States</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>in</B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>Foreign</B></P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>Countries</B></P></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Mednax Services, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">Florida</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">Physician&nbsp;Services</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">15</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Pediatrix Medical Group, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">Florida</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">Physician Services</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">American Anesthesiology, Inc.</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">Florida</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">Physician Services</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">9</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
</TABLE>
</DIV></Center>

</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-23.1
<SEQUENCE>7
<FILENAME>d671465dex231.htm
<DESCRIPTION>EX-23.1
<TEXT>
<HTML><HEAD>
<TITLE>EX-23.1</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">

 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="right"><B>Exhibit 23.1 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">We hereby consent to the incorporation by reference in the Registration Statements on Form <FONT STYLE="white-space:nowrap">S-8</FONT> (Nos. <FONT
STYLE="white-space:nowrap">333-181667,</FONT> <FONT STYLE="white-space:nowrap">333-153397,</FONT> <FONT STYLE="white-space:nowrap">333-151272,</FONT> <FONT STYLE="white-space:nowrap">333-121125,</FONT>
<FONT STYLE="white-space:nowrap">333-101225,</FONT> <FONT STYLE="white-space:nowrap">333-85366,</FONT> and <FONT STYLE="white-space:nowrap">333-208698)</FONT> of MEDNAX, Inc. and its subsidiaries of our report dated February&nbsp;14, 2019 relating
to the financial statements and the effectiveness of internal control over financial reporting, which appears in the Annual Report to Shareholders, which is incorporated in this Annual Report on Form <FONT STYLE="white-space:nowrap">10-K.</FONT> We
also consent to the incorporation by reference of our report dated February&nbsp;14, 2019 relating to the financial statement schedule, which appears in this Form <FONT STYLE="white-space:nowrap">10-K.</FONT> </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">/s/ Pricewaterhouse Coopers LLP </P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Certified Public Accountants
Miami, Florida February&nbsp;14, 2019 </P>
</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-31.1
<SEQUENCE>8
<FILENAME>d671465dex311.htm
<DESCRIPTION>EX-31.1
<TEXT>
<HTML><HEAD>
<TITLE>EX-31.1</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">

 <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><U>CERTIFICATIONS </U></B></P> <P STYLE="margin-top:12pt; 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 annual report on Form <FONT STYLE="white-space:nowrap">10-K</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: February&nbsp;14, 2019 </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"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">By:</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"> <P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1px solid #000000; font-size:10pt; font-family:Times New Roman">/s/ 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" COLSPAN="3"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">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" COLSPAN="3"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Chief Executive Officer</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">(Principal Executive Officer)</P></TD></TR>
</TABLE></DIV> <P STYLE="font-size:18pt; margin-top:0pt; margin-bottom:0pt">&nbsp;</P>
</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-31.2
<SEQUENCE>9
<FILENAME>d671465dex312.htm
<DESCRIPTION>EX-31.2
<TEXT>
<HTML><HEAD>
<TITLE>EX-31.2</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">

 <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><U>CERTIFICATIONS </U></B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">I, Stephen D.
Farber, 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 annual report on Form <FONT STYLE="white-space:nowrap">10-K</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: February&nbsp;14, 2019 </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/ Stephen D. Farber</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">Stephen D. Farber</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">Chief Financial Officer</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">(Principal Financial Officer)</P></TD></TR>
</TABLE></DIV>
</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-32
<SEQUENCE>10
<FILENAME>d671465dex32.htm
<DESCRIPTION>EX-32
<TEXT>
<HTML><HEAD>
<TITLE>EX-32</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">

 <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 Annual Report of MEDNAX, Inc. on Form <FONT STYLE="white-space:nowrap">10-K</FONT> for the year ended December&nbsp;31,
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">February&nbsp;14, 2019 </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" COLSPAN="3">Roger J. Medel, M.D.</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">Chief Executive Officer</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">(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/ Stephen D. Farber</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">Stephen D. Farber</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3">Chief Financial Officer</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">(Principal Financial Officer)</P></TD></TR>
</TABLE>
</BODY></HTML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.INS
<SEQUENCE>11
<FILENAME>md-20181231.xml
<DESCRIPTION>XBRL INSTANCE DOCUMENT
<TEXT>
<XBRL>
<?xml version="1.0" encoding="us-ascii" standalone="yes"?>
<!-- DFS Xcelerate Instance Document - http://www.dfsco.com/financial-services/ -->
<!-- Version:  6.23.6 -->
<!-- Round: 4 -->
<!-- Creation date: 2019-02-13T01:59:33Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
<xbrl xmlns="http://www.xbrl.org/2003/instance" xmlns:xbrll="http://www.xbrl.org/2003/linkbase" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:iso4217="http://www.xbrl.org/2003/iso4217" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:us-gaap="http://fasb.org/us-gaap/2018-01-31" xmlns:dei="http://xbrl.sec.gov/dei/2018-01-31" xmlns:md="http://www.mednax.com/20181231" xmlns:us-types="http://fasb.org/us-types/2018-01-31" xmlns:xbrldt="http://xbrl.org/2005/xbrldt" xmlns:xbrldi="http://xbrl.org/2006/xbrldi" xmlns:stpr="http://xbrl.sec.gov/stpr/2018-01-31" xmlns:country="http://xbrl.sec.gov/country/2017-01-31" xmlns:currency="http://xbrl.sec.gov/currency/2017-01-31" xmlns:exch="http://xbrl.sec.gov/exch/2018-01-31" xmlns:naics="http://xbrl.sec.gov/naics/2017-01-31" xmlns:invest="http://xbrl.sec.gov/invest/2013-01-31" xmlns:sic="http://xbrl.sec.gov/sic/2011-01-31" xmlns:negated="http://www.xbrl.org/2009/role/negated" xmlns:num="http://www.xbrl.org/dtr/type/numeric" xmlns:nonnum="http://www.xbrl.org/dtr/type/non-numeric" xmlns:utr="http://www.xbrl.org/2009/utr" xmlns:srt-types="http://fasb.org/srt-types/2018-01-31" xmlns:srt="http://fasb.org/srt/2018-01-31">
  <xbrll:schemaRef xlink:type="simple" xlink:arcrole="http://www.xbrl.org/2003/linkbase" xlink:href="md-20181231.xsd" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xbrll="http://www.xbrl.org/2003/linkbase" />
  <us-gaap:EquityMethodInvestmentOwnershipPercentage contextRef="eol_PE10840---1810-K0015_STD_0_20180131_0_3079978x3295964" unitRef="pure" decimals="3" id="id_14062202_0C99C5A3-919E-4E6A-A981-806624504C29_1002_0">0.490</us-gaap:EquityMethodInvestmentOwnershipPercentage>
  <us-gaap:DebtInstrumentInterestRateStatedPercentage contextRef="eol_PE10840---1810-K0015_STD_0_20181130_0_3066013x3538202" unitRef="pure" decimals="INF" id="id_14062202_88F8ACFD-9463-4F4F-928E-5314380120AB_1002_1">0.0625</us-gaap:DebtInstrumentInterestRateStatedPercentage>
  <us-gaap:DebtInstrumentFaceAmount contextRef="eol_PE10840---1810-K0015_STD_0_20181130_0_3066013x3538202" unitRef="iso4217_USD" decimals="-5" id="id_14062202_88F8ACFD-9463-4F4F-928E-5314380120AB_1002_0">500000000</us-gaap:DebtInstrumentFaceAmount>
  <dei:EntityCommonStockSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_0_20190207_0" unitRef="shares" decimals="INF" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_2_12">87920463</dei:EntityCommonStockSharesOutstanding>
  <md:UnrecognizedTaxBenefitsImpactEffectiveTaxRate contextRef="eol_PE10840---1810-K0015_STD_0_20160930_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_825CA47E-8C6C-4752-B30C-4D0591235E93_1004_3">10600000</md:UnrecognizedTaxBenefitsImpactEffectiveTaxRate>
  <dei:EntityPublicFloat contextRef="eol_PE10840---1810-K0015_STD_0_20180630_0" unitRef="iso4217_USD" decimals="0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_3_13">3943237534</dei:EntityPublicFloat>
  <us-gaap:StockRepurchaseProgramAuthorizedAmount1 contextRef="eol_PE10840---1810-K0015_STD_0_20180831_0" unitRef="iso4217_USD" decimals="INF" id="id_14062202_288B2541-9D2C-4407-865B-2AE7E75C8C0F_1001_0">500000000</us-gaap:StockRepurchaseProgramAuthorizedAmount1>
  <us-gaap:AcceleratedShareRepurchasesSettlementPaymentOrReceipt contextRef="eol_PE10840---1810-K0015_STD_0_20180831_0_3081082x3275817" unitRef="iso4217_USD" decimals="-5" id="id_14062202_4A9B4BE2-A296-40A0-A94F-0FF2B3076A33_1001_0">250000000</us-gaap:AcceleratedShareRepurchasesSettlementPaymentOrReceipt>
  <us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents contextRef="eol_PE10840---1810-K0015_STD_0_20151231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2001_39">51572000</us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents>
  <us-gaap:MalpracticeLossContingencyAccrualUndiscounted contextRef="eol_PE10840---1810-K0015_STD_0_20151231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_2001_0">202527000</us-gaap:MalpracticeLossContingencyAccrualUndiscounted>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20151231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_1006_900001">2437846000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:UnrecognizedTaxBenefits contextRef="eol_PE10840---1810-K0015_STD_0_20151231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_2001_0">18447000</us-gaap:UnrecognizedTaxBenefits>
  <us-gaap:DebtInstrumentInterestRateStatedPercentage contextRef="eol_PE10840---1810-K0015_STD_0_20151231_0_3066013x3297729" unitRef="pure" decimals="INF" id="id_14062202_88F8ACFD-9463-4F4F-928E-5314380120AB_1001_1">0.0525</us-gaap:DebtInstrumentInterestRateStatedPercentage>
  <us-gaap:DebtInstrumentFaceAmount contextRef="eol_PE10840---1810-K0015_STD_0_20151231_0_3066013x3297729" unitRef="iso4217_USD" decimals="-5" id="id_14062202_88F8ACFD-9463-4F4F-928E-5314380120AB_1001_0">750000000</us-gaap:DebtInstrumentFaceAmount>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20151231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_1003_600001">926235000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20151231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_1001_500001">937000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:SharesIssued contextRef="eol_PE10840---1810-K0015_STD_0_20151231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_1001_400002">93739000</us-gaap:SharesIssued>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20151231_0_3080925x3076080" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_1005_800001">318000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20151231_0_3080925x3078149" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_1004_700001">1510356000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents contextRef="eol_PE10840---1810-K0015_STD_0_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1003_39">55698000</us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents>
  <us-gaap:MalpracticeLossContingencyAccrualUndiscounted contextRef="eol_PE10840---1810-K0015_STD_0_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_1003_0">202052000</us-gaap:MalpracticeLossContingencyAccrualUndiscounted>
  <us-gaap:OperatingLossCarryforwards contextRef="eol_PE10840---1810-K0015_STD_0_20161231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_534D1136-F996-4605-A930-CB1498AA2308_1003_0">130000000</us-gaap:OperatingLossCarryforwards>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_3006_900014">2760767000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:UnrecognizedTaxBenefits contextRef="eol_PE10840---1810-K0015_STD_0_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E1008F61-D7C7-446D-BA10-6A31C276998B_1003_0">9469000</us-gaap:UnrecognizedTaxBenefits>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20161231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_3003_600014">974304000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20161231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_3001_500014">937000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:SharesIssued contextRef="eol_PE10840---1810-K0015_STD_0_20161231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_3001_400015">93718000</us-gaap:SharesIssued>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20161231_0_3080925x3078149" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_3004_700014">1785526000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:AssetsCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_8">627235000</us-gaap:AssetsCurrent>
  <us-gaap:AccruedIncomeTaxesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_20">92007000</us-gaap:AccruedIncomeTaxesCurrent>
  <us-gaap:AllowanceForDoubtfulAccountsReceivableCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2705685C-B101-467E-AAAE-046F7736A5EF_2_1">1286035000</us-gaap:AllowanceForDoubtfulAccountsReceivableCurrent>
  <us-gaap:AccountsReceivableNetCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_5">503999000</us-gaap:AccountsReceivableNetCurrent>
  <us-gaap:AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BFF7946D-A10A-403B-892A-5D889E0E8A00_2_4">169624000</us-gaap:AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment>
  <us-gaap:AdditionalPaidInCapitalCommonStock contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_39">1017328000</us-gaap:AdditionalPaidInCapitalCommonStock>
  <us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_2_7">438017000</us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent>
  <us-gaap:AccountsPayableCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_2_0">34632000</us-gaap:AccountsPayableCurrent>
  <us-gaap:AccountsReceivableGrossCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2705685C-B101-467E-AAAE-046F7736A5EF_2_0">1790034000</us-gaap:AccountsReceivableGrossCurrent>
  <us-gaap:AccruedSalariesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_2_1">225429000</us-gaap:AccruedSalariesCurrent>
  <us-gaap:Assets contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_15">5867278000</us-gaap:Assets>
  <us-gaap:BuildingsAndImprovementsGross contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BFF7946D-A10A-403B-892A-5D889E0E8A00_2_0">33024000</us-gaap:BuildingsAndImprovementsGross>
  <us-gaap:CapitalLeaseObligations contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8318B172-848F-4C31-8D3A-E175E34BB3E4_2_0">1826000</us-gaap:CapitalLeaseObligations>
  <us-gaap:CapitalLeaseObligationsCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8318B172-848F-4C31-8D3A-E175E34BB3E4_2_1">1401000</us-gaap:CapitalLeaseObligationsCurrent>
  <us-gaap:CapitalLeaseObligationsNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8318B172-848F-4C31-8D3A-E175E34BB3E4_2_2">425000</us-gaap:CapitalLeaseObligationsNoncurrent>
  <us-gaap:BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_15181987-80B3-407C-A0EA-AD3CE55135F1_1002_0">30500000</us-gaap:BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized>
  <us-gaap:CashSurrenderValueFairValueDisclosure contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_998204C7-BDE6-4BCB-B981-62FE8BE38D5E_2_0">15600000</us-gaap:CashSurrenderValueFairValueDisclosure>
  <us-gaap:CashAndCashEquivalentsAtCarryingValue contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_2">60200000</us-gaap:CashAndCashEquivalentsAtCarryingValue>
  <us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1002_39">80200000</us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents>
  <us-gaap:CommitmentsAndContingencies contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" xsi:nil="true" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_28" />
  <us-gaap:CommonStockSharesAuthorized contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="shares" decimals="INF" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_36">200000000</us-gaap:CommonStockSharesAuthorized>
  <us-gaap:CommonStockSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="shares" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_38">93721000</us-gaap:CommonStockSharesOutstanding>
  <us-gaap:CommonStockParOrStatedValuePerShare contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD_per_shares" decimals="INF" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_35">0.01</us-gaap:CommonStockParOrStatedValuePerShare>
  <us-gaap:CommonStockSharesIssued contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="shares" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_37">93721000</us-gaap:CommonStockSharesIssued>
  <us-gaap:CommonStockValue contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_34">937000</us-gaap:CommonStockValue>
  <us-gaap:DeferredIncomeTaxLiabilities contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_14">294058000</us-gaap:DeferredIncomeTaxLiabilities>
  <us-gaap:DebtInstrumentCarryingAmount contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_898F6FB6-D5D6-4B6A-80FB-E4F8ED9B0C3E_1001_6">1860500000</us-gaap:DebtInstrumentCarryingAmount>
  <us-gaap:DeferredTaxAssetsOther contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_5">970000</us-gaap:DeferredTaxAssetsOther>
  <us-gaap:DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_1">45454000</us-gaap:DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves>
  <us-gaap:DeferredTaxAssetsValuationAllowance contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_7">2615000</us-gaap:DeferredTaxAssetsValuationAllowance>
  <us-gaap:DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_10">258618000</us-gaap:DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets>
  <us-gaap:DeferredTaxAssetsOperatingLossCarryforwards contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_3">28569000</us-gaap:DeferredTaxAssetsOperatingLossCarryforwards>
  <us-gaap:DeferredTaxLiabilitiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_25">147797000</us-gaap:DeferredTaxLiabilitiesNoncurrent>
  <us-gaap:DeferredTaxAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_6">163709000</us-gaap:DeferredTaxAssetsGross>
  <us-gaap:DeferredTaxAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_8">161094000</us-gaap:DeferredTaxAssetsNet>
  <us-gaap:DeferredTaxAssetsPropertyPlantAndEquipment contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_4">685000</us-gaap:DeferredTaxAssetsPropertyPlantAndEquipment>
  <us-gaap:DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_2">7975000</us-gaap:DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost>
  <us-gaap:DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_0">80056000</us-gaap:DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts>
  <us-gaap:DeferredTaxLiabilities contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_15">132964000</us-gaap:DeferredTaxLiabilities>
  <us-gaap:DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_12">31290000</us-gaap:DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals>
  <us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1010_2">266753000</us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization>
  <us-gaap:FiniteLivedIntangibleAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1010_1">906681000</us-gaap:FiniteLivedIntangibleAssetsGross>
  <us-gaap:FiniteLivedIntangibleAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_13">639928000</us-gaap:FiniteLivedIntangibleAssetsNet>
  <us-gaap:FixturesAndEquipmentGross contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BFF7946D-A10A-403B-892A-5D889E0E8A00_2_2">253453000</us-gaap:FixturesAndEquipmentGross>
  <us-gaap:Goodwill contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_12">4283963000</us-gaap:Goodwill>
  <us-gaap:HeldToMaturitySecuritiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_4">10292000</us-gaap:HeldToMaturitySecuritiesCurrent>
  <us-gaap:HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BF7CB75C-2F65-4506-A8FE-6F6CB1CB69C5_2_1">2121000</us-gaap:HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount>
  <us-gaap:IncomeTaxExaminationPenaltiesAndInterestAccrued contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_6C8DDD61-305F-4BD0-A872-046929E36F97_4_1">1200000</us-gaap:IncomeTaxExaminationPenaltiesAndInterestAccrued>
  <us-gaap:HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BF7CB75C-2F65-4506-A8FE-6F6CB1CB69C5_2_0">78561000</us-gaap:HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount>
  <us-gaap:HeldToMaturitySecuritiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_10">80682000</us-gaap:HeldToMaturitySecuritiesNoncurrent>
  <us-gaap:InterestPayableCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_2_5">4495000</us-gaap:InterestPayableCurrent>
  <us-gaap:LiabilitiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_21">531425000</us-gaap:LiabilitiesCurrent>
  <us-gaap:Land contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BFF7946D-A10A-403B-892A-5D889E0E8A00_2_1">6683000</us-gaap:Land>
  <us-gaap:Liabilities contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_27">2800824000</us-gaap:Liabilities>
  <us-gaap:LiabilitiesAndStockholdersEquity contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_42">5867278000</us-gaap:LiabilitiesAndStockholdersEquity>
  <us-gaap:LongTermDebt contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_B606F8C7-1C2C-4BAC-8BFB-7C8C5CF8E679_1002_0">1846133000</us-gaap:LongTermDebt>
  <us-gaap:MalpracticeLossContingencyAccrualUndiscounted contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_1002_0">250187000</us-gaap:MalpracticeLossContingencyAccrualUndiscounted>
  <us-gaap:LongTermDebtAndCapitalLeaseObligationsCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_19">1401000</us-gaap:LongTermDebtAndCapitalLeaseObligationsCurrent>
  <us-gaap:MalpracticeLossContingencyAccrualUndiscountedCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_2_3">37912000</us-gaap:MalpracticeLossContingencyAccrualUndiscountedCurrent>
  <us-gaap:LongTermLineOfCredit contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_22">1110500000</us-gaap:LongTermLineOfCredit>
  <us-gaap:MalpracticeLossContingencyAccrualUndiscountedNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_24">212274000</us-gaap:MalpracticeLossContingencyAccrualUndiscountedNoncurrent>
  <us-gaap:OtherAccruedLiabilitiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_2_6">53618000</us-gaap:OtherAccruedLiabilitiesCurrent>
  <us-gaap:OtherAssetsCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_7">37160000</us-gaap:OtherAssetsCurrent>
  <us-gaap:OperatingLossCarryforwards contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_534D1136-F996-4605-A930-CB1498AA2308_1002_0">116000000</us-gaap:OperatingLossCarryforwards>
  <us-gaap:OtherAssetsNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_14">91934000</us-gaap:OtherAssetsNoncurrent>
  <us-gaap:PrepaidExpenseCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_6">15584000</us-gaap:PrepaidExpenseCurrent>
  <us-gaap:OtherLiabilitiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_26">57905000</us-gaap:OtherLiabilitiesNoncurrent>
  <us-gaap:PropertyPlantAndEquipmentNet contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_11">123536000</us-gaap:PropertyPlantAndEquipmentNet>
  <us-gaap:PreferredStockParOrStatedValuePerShare contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD_per_shares" decimals="INF" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_31">0.01</us-gaap:PreferredStockParOrStatedValuePerShare>
  <us-gaap:PreferredStockSharesAuthorized contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="shares" decimals="INF" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_32">1000000</us-gaap:PreferredStockSharesAuthorized>
  <us-gaap:PreferredStockValue contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" xsi:nil="true" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_30" />
  <us-gaap:PreferredStockSharesIssued contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="shares" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_33">0</us-gaap:PreferredStockSharesIssued>
  <us-gaap:PropertyPlantAndEquipmentGross contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BFF7946D-A10A-403B-892A-5D889E0E8A00_2_3">293160000</us-gaap:PropertyPlantAndEquipmentGross>
  <us-gaap:RetainedEarningsAccumulatedDeficit contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_40">2048189000</us-gaap:RetainedEarningsAccumulatedDeficit>
  <us-gaap:RestrictedCashNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_9">20000000</us-gaap:RestrictedCashNoncurrent>
  <us-gaap:SelfInsuranceReserveCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_609B363D-15A0-4650-B9EC-81F0476B2A5F_2_1">138500000</us-gaap:SelfInsuranceReserveCurrent>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_958A4CD4-6EDD-49A8-968D-37A72B84DCD2_2001_0">60.21</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_5006_900028">3066454000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="shares" decimals="INF" id="id_14062202_AE5979A1-5C5C-4795-B5D0-5850CB9AC220_2001_0">1041034</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="shares" decimals="INF" id="id_14062202_3762BF2C-F2D8-4F6B-B25C-39FCD11E9EE4_2001_0">246342</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_D2B45BBF-A5C6-413E-A194-CDE6AFBFE25D_2001_0">27.51</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice>
  <us-gaap:UnamortizedDebtIssuanceExpense contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_A5B7B805-120B-49EC-B027-5AF8048FDA08_1001_6">14367000</us-gaap:UnamortizedDebtIssuanceExpense>
  <us-gaap:StockholdersEquity contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_41">3066454000</us-gaap:StockholdersEquity>
  <us-gaap:UnrecognizedTaxBenefits contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E1008F61-D7C7-446D-BA10-6A31C276998B_1002_0">10972000</us-gaap:UnrecognizedTaxBenefits>
  <md:AccruedProfessionalLiability contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_609B363D-15A0-4650-B9EC-81F0476B2A5F_2_2">111700000</md:AccruedProfessionalLiability>
  <md:MoneyMarketFundsAtFairValue contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_1EB48F8E-4DC5-41B3-A138-61A50FDB2155_2_0">9200000</md:MoneyMarketFundsAtFairValue>
  <md:AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_18">438017000</md:AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent>
  <md:AccruedPayrollTaxesAndBenefitsCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_2_2">75672000</md:AccruedPayrollTaxesAndBenefitsCurrent>
  <md:LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_2_23">740923000</md:LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit>
  <md:AccruedContingentConsiderationLiabilityCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_2_4">6259000</md:AccruedContingentConsiderationLiabilityCurrent>
  <md:DeferredTaxLiabilitiesChangeInAccountingMethod contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_2_11">4150000</md:DeferredTaxLiabilitiesChangeInAccountingMethod>
  <us-gaap:DebtInstrumentCarryingAmount contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3066013x3078864" unitRef="iso4217_USD" decimals="-3" id="id_14062202_898F6FB6-D5D6-4B6A-80FB-E4F8ED9B0C3E_2001_5">1110500000</us-gaap:DebtInstrumentCarryingAmount>
  <us-gaap:LongTermDebt contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3066013x3078864" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6FC96681-B499-42A4-A974-A7DC2EC1B4AC_2001_5">1105636000</us-gaap:LongTermDebt>
  <us-gaap:UnamortizedDebtIssuanceExpense contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3066013x3078864" unitRef="iso4217_USD" decimals="-3" id="id_14062202_A5B7B805-120B-49EC-B027-5AF8048FDA08_2001_5">4864000</us-gaap:UnamortizedDebtIssuanceExpense>
  <us-gaap:DebtInstrumentCarryingAmount contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3066013x3297729" unitRef="iso4217_USD" decimals="-3" id="id_14062202_898F6FB6-D5D6-4B6A-80FB-E4F8ED9B0C3E_3001_4">750000000</us-gaap:DebtInstrumentCarryingAmount>
  <us-gaap:LongTermDebt contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3066013x3297729" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6FC96681-B499-42A4-A974-A7DC2EC1B4AC_3001_4">740497000</us-gaap:LongTermDebt>
  <us-gaap:UnamortizedDebtIssuanceExpense contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3066013x3297729" unitRef="iso4217_USD" decimals="-3" id="id_14062202_A5B7B805-120B-49EC-B027-5AF8048FDA08_3001_4">9503000</us-gaap:UnamortizedDebtIssuanceExpense>
  <us-gaap:NotesPayableFairValueDisclosure contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3066013x3297729_3068684x3070091_3070058x3068644" unitRef="iso4217_USD" decimals="-3" id="id_14062202_56503278-D8FE-4DEA-AFB7-67FCF25A3F6B_1002_0">763125000</us-gaap:NotesPayableFairValueDisclosure>
  <us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3066421" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1007_2">48837000</us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization>
  <us-gaap:FiniteLivedIntangibleAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3066421" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1007_1">443300000</us-gaap:FiniteLivedIntangibleAssetsGross>
  <us-gaap:FiniteLivedIntangibleAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3066421" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1007_3">394463000</us-gaap:FiniteLivedIntangibleAssetsNet>
  <us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3081468" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1008_2">2933000</us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization>
  <us-gaap:FiniteLivedIntangibleAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3081468" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1008_1">43156000</us-gaap:FiniteLivedIntangibleAssetsGross>
  <us-gaap:FiniteLivedIntangibleAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3081468" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1008_3">40223000</us-gaap:FiniteLivedIntangibleAssetsNet>
  <us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3253046" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1009_2">11068000</us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization>
  <us-gaap:FiniteLivedIntangibleAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3253046" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1009_1">38590000</us-gaap:FiniteLivedIntangibleAssetsGross>
  <us-gaap:FiniteLivedIntangibleAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3253046" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1009_3">27522000</us-gaap:FiniteLivedIntangibleAssetsNet>
  <us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3294255" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1006_2">203915000</us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization>
  <us-gaap:FiniteLivedIntangibleAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3294255" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1006_1">381635000</us-gaap:FiniteLivedIntangibleAssetsGross>
  <us-gaap:FiniteLivedIntangibleAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3294255" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1006_3">177720000</us-gaap:FiniteLivedIntangibleAssetsNet>
  <us-gaap:HeldToMaturitySecuritiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3073527x3065535" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_1003_3">980000</us-gaap:HeldToMaturitySecuritiesCurrent>
  <us-gaap:HeldToMaturitySecuritiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3073527x3065535" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_1003_4">4165000</us-gaap:HeldToMaturitySecuritiesNoncurrent>
  <us-gaap:HeldToMaturitySecuritiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3073527x3081528" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_1002_3">1000000</us-gaap:HeldToMaturitySecuritiesCurrent>
  <us-gaap:HeldToMaturitySecuritiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3073527x3081528" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_1002_4">30322000</us-gaap:HeldToMaturitySecuritiesNoncurrent>
  <us-gaap:HeldToMaturitySecuritiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3073527x3081530" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_1001_3">8312000</us-gaap:HeldToMaturitySecuritiesCurrent>
  <us-gaap:HeldToMaturitySecuritiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3073527x3081530" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_1001_4">46195000</us-gaap:HeldToMaturitySecuritiesNoncurrent>
  <us-gaap:AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3078429x3252751" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5AB7E65F-6B18-4C0B-979C-191C7614027B_1002_1">4600000</us-gaap:AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment>
  <us-gaap:PropertyPlantAndEquipmentGross contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3078429x3252751" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5AB7E65F-6B18-4C0B-979C-191C7614027B_1002_0">6100000</us-gaap:PropertyPlantAndEquipmentGross>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_5003_600028">1017328000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_5001_500028">937000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:SharesIssued contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_5001_400029">93721000</us-gaap:SharesIssued>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20171231_0_3080925x3078149" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_5004_700028">2048189000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:AssetsCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_8">657409000</us-gaap:AssetsCurrent>
  <us-gaap:AssetsHeldForSaleNotPartOfDisposalGroup contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_76D45BAC-7B29-4568-B22E-8299409E7AFD_1_0">46000000</us-gaap:AssetsHeldForSaleNotPartOfDisposalGroup>
  <us-gaap:AccruedIncomeTaxesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_20">30598000</us-gaap:AccruedIncomeTaxesCurrent>
  <us-gaap:AllowanceForDoubtfulAccountsReceivableCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2705685C-B101-467E-AAAE-046F7736A5EF_1_1">1489069000</us-gaap:AllowanceForDoubtfulAccountsReceivableCurrent>
  <us-gaap:AccountsReceivableNetCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_5">542272000</us-gaap:AccountsReceivableNetCurrent>
  <us-gaap:AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BFF7946D-A10A-403B-892A-5D889E0E8A00_1_4">207816000</us-gaap:AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment>
  <us-gaap:AdditionalPaidInCapitalCommonStock contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_39">992647000</us-gaap:AdditionalPaidInCapitalCommonStock>
  <us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_1_7">469342000</us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent>
  <us-gaap:AccountsPayableCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_1_0">31059000</us-gaap:AccountsPayableCurrent>
  <us-gaap:AccountsReceivableGrossCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2705685C-B101-467E-AAAE-046F7736A5EF_1_0">2031341000</us-gaap:AccountsReceivableGrossCurrent>
  <us-gaap:AccruedSalariesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_1_1">249834000</us-gaap:AccruedSalariesCurrent>
  <us-gaap:Assets contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_15">5934911000</us-gaap:Assets>
  <us-gaap:BuildingsAndImprovementsGross contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BFF7946D-A10A-403B-892A-5D889E0E8A00_1_0">33189000</us-gaap:BuildingsAndImprovementsGross>
  <us-gaap:CapitalLeaseObligations contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8318B172-848F-4C31-8D3A-E175E34BB3E4_1_0">441000</us-gaap:CapitalLeaseObligations>
  <us-gaap:CapitalLeaseObligationsCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8318B172-848F-4C31-8D3A-E175E34BB3E4_1_1">253000</us-gaap:CapitalLeaseObligationsCurrent>
  <us-gaap:CapitalLeaseObligationsNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8318B172-848F-4C31-8D3A-E175E34BB3E4_1_2">188000</us-gaap:CapitalLeaseObligationsNoncurrent>
  <us-gaap:BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_4623442B-D13E-4123-AD46-F9D0706315D4_1001_400002">63000000</us-gaap:BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount>
  <us-gaap:BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_15181987-80B3-407C-A0EA-AD3CE55135F1_1001_0">20000000</us-gaap:BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized>
  <us-gaap:CapitalLeasesFutureMinimumPaymentsDueCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F89DB49B-B189-4156-8F8A-2074683973F6_1001_0">253000</us-gaap:CapitalLeasesFutureMinimumPaymentsDueCurrent>
  <us-gaap:CashSurrenderValueFairValueDisclosure contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_998204C7-BDE6-4BCB-B981-62FE8BE38D5E_1_0">10500000</us-gaap:CashSurrenderValueFairValueDisclosure>
  <us-gaap:CapitalLeasesFutureMinimumPaymentsDueInThreeYears contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F89DB49B-B189-4156-8F8A-2074683973F6_1001_2">74000</us-gaap:CapitalLeasesFutureMinimumPaymentsDueInThreeYears>
  <us-gaap:CashAndCashEquivalentsAtCarryingValue contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_2">36745000</us-gaap:CashAndCashEquivalentsAtCarryingValue>
  <us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1001_40">56745000</us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents>
  <us-gaap:CommitmentsAndContingencies contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" xsi:nil="true" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_28" />
  <us-gaap:CommonStockSharesAuthorized contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="shares" decimals="INF" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_36">200000000</us-gaap:CommonStockSharesAuthorized>
  <us-gaap:CommonStockSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="shares" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_38">87820000</us-gaap:CommonStockSharesOutstanding>
  <us-gaap:CapitalLeasesFutureMinimumPaymentsDueInTwoYears contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F89DB49B-B189-4156-8F8A-2074683973F6_1001_1">114000</us-gaap:CapitalLeasesFutureMinimumPaymentsDueInTwoYears>
  <us-gaap:CommonStockParOrStatedValuePerShare contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD_per_shares" decimals="INF" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_35">0.01</us-gaap:CommonStockParOrStatedValuePerShare>
  <us-gaap:CommonStockSharesIssued contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="shares" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_37">87820000</us-gaap:CommonStockSharesIssued>
  <us-gaap:CommonStockValue contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_34">878000</us-gaap:CommonStockValue>
  <us-gaap:DeferredIncomeTaxLiabilities contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_14">396498000</us-gaap:DeferredIncomeTaxLiabilities>
  <us-gaap:DebtInstrumentCarryingAmount contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_898F6FB6-D5D6-4B6A-80FB-E4F8ED9B0C3E_7001_3">1989500000</us-gaap:DebtInstrumentCarryingAmount>
  <us-gaap:DeferredTaxAssetsOther contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_5">1197000</us-gaap:DeferredTaxAssetsOther>
  <us-gaap:DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_1">59270000</us-gaap:DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves>
  <us-gaap:DeferredTaxAssetsValuationAllowance contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_7">2628000</us-gaap:DeferredTaxAssetsValuationAllowance>
  <us-gaap:DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_10">286552000</us-gaap:DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets>
  <us-gaap:DeferredTaxAssetsOperatingLossCarryforwards contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_3">25226000</us-gaap:DeferredTaxAssetsOperatingLossCarryforwards>
  <us-gaap:DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_534D1136-F996-4605-A930-CB1498AA2308_1001_3">27600000</us-gaap:DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration>
  <us-gaap:DeferredTaxLiabilitiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_25">131240000</us-gaap:DeferredTaxLiabilitiesNoncurrent>
  <us-gaap:DeferredTaxAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_6">289796000</us-gaap:DeferredTaxAssetsGross>
  <us-gaap:DeferredTaxAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_8">287168000</us-gaap:DeferredTaxAssetsNet>
  <us-gaap:DeferredTaxLiabilitiesOther contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_13">489000</us-gaap:DeferredTaxLiabilitiesOther>
  <us-gaap:DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_534D1136-F996-4605-A930-CB1498AA2308_1001_2">74300000</us-gaap:DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration>
  <us-gaap:DeferredTaxAssetsPropertyPlantAndEquipment contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_4">26000</us-gaap:DeferredTaxAssetsPropertyPlantAndEquipment>
  <us-gaap:DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_2">9201000</us-gaap:DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost>
  <us-gaap:DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_0">194876000</us-gaap:DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts>
  <us-gaap:DeferredTaxLiabilities contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_15">109330000</us-gaap:DeferredTaxLiabilities>
  <us-gaap:DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_12">39000</us-gaap:DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals>
  <us-gaap:EquityMethodInvestmentOwnershipPercentage contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="pure" decimals="3" id="id_14062202_76D45BAC-7B29-4568-B22E-8299409E7AFD_1_1">0.490</us-gaap:EquityMethodInvestmentOwnershipPercentage>
  <us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1005_2">322576000</us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization>
  <us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BE5F801E-C4AD-4FA5-815B-401B0E38D952_1001_0">66532000</us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths>
  <us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseYearFour contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BE5F801E-C4AD-4FA5-815B-401B0E38D952_1001_3">46249000</us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseYearFour>
  <us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseYearFive contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BE5F801E-C4AD-4FA5-815B-401B0E38D952_1001_4">40448000</us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseYearFive>
  <us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseYearThree contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BE5F801E-C4AD-4FA5-815B-401B0E38D952_1001_2">53771000</us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseYearThree>
  <us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BE5F801E-C4AD-4FA5-815B-401B0E38D952_1001_1">59969000</us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo>
  <us-gaap:FiniteLivedIntangibleAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1005_1">910888000</us-gaap:FiniteLivedIntangibleAssetsGross>
  <us-gaap:FiniteLivedIntangibleAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_13">588312000</us-gaap:FiniteLivedIntangibleAssetsNet>
  <us-gaap:FixturesAndEquipmentGross contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BFF7946D-A10A-403B-892A-5D889E0E8A00_1_2">300981000</us-gaap:FixturesAndEquipmentGross>
  <us-gaap:Goodwill contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_12">4382995000</us-gaap:Goodwill>
  <us-gaap:HeldToMaturitySecuritiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_4">21923000</us-gaap:HeldToMaturitySecuritiesCurrent>
  <us-gaap:IncomeTaxExaminationPenaltiesAndInterestAccrued contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_6C8DDD61-305F-4BD0-A872-046929E36F97_3_1">1100000</us-gaap:IncomeTaxExaminationPenaltiesAndInterestAccrued>
  <us-gaap:HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BF7CB75C-2F65-4506-A8FE-6F6CB1CB69C5_1_0">69699000</us-gaap:HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount>
  <us-gaap:HeldToMaturitySecuritiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_10">69699000</us-gaap:HeldToMaturitySecuritiesNoncurrent>
  <us-gaap:InsuranceSettlementsReceivable contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_609B363D-15A0-4650-B9EC-81F0476B2A5F_1_4">16700000</us-gaap:InsuranceSettlementsReceivable>
  <us-gaap:InterestPayableCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_1_5">9477000</us-gaap:InterestPayableCurrent>
  <us-gaap:LiabilitiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_21">500193000</us-gaap:LiabilitiesCurrent>
  <us-gaap:LineOfCreditFacilityRemainingBorrowingCapacity contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-8" id="id_14062202_B0A5A8DB-0F7D-4706-AB12-D99859053107_1001_1">1300000000</us-gaap:LineOfCreditFacilityRemainingBorrowingCapacity>
  <us-gaap:Land contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BFF7946D-A10A-403B-892A-5D889E0E8A00_1_1">6683000</us-gaap:Land>
  <us-gaap:LettersOfCreditOutstandingAmount contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_B0A5A8DB-0F7D-4706-AB12-D99859053107_1001_0">200000</us-gaap:LettersOfCreditOutstandingAmount>
  <us-gaap:Liabilities contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_27">2847027000</us-gaap:Liabilities>
  <us-gaap:LiabilitiesAndStockholdersEquity contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_42">5934911000</us-gaap:LiabilitiesAndStockholdersEquity>
  <us-gaap:LongTermDebt contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_B606F8C7-1C2C-4BAC-8BFB-7C8C5CF8E679_1001_0">1969818000</us-gaap:LongTermDebt>
  <us-gaap:MalpracticeLossContingencyAccrualUndiscounted contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_1001_8">243991000</us-gaap:MalpracticeLossContingencyAccrualUndiscounted>
  <us-gaap:LongTermDebtAndCapitalLeaseObligationsCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_19">253000</us-gaap:LongTermDebtAndCapitalLeaseObligationsCurrent>
  <us-gaap:MalpracticeLossContingencyAccrualUndiscountedCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_1_3">34931000</us-gaap:MalpracticeLossContingencyAccrualUndiscountedCurrent>
  <us-gaap:LongTermLineOfCredit contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_22">739500000</us-gaap:LongTermLineOfCredit>
  <us-gaap:OperatingLeasesFutureMinimumPaymentsDueThereafter contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_79071DA6-9EF5-4CBD-9CC3-976A65BE18CC_1001_5">10522000</us-gaap:OperatingLeasesFutureMinimumPaymentsDueThereafter>
  <us-gaap:MalpracticeLossContingencyAccrualUndiscountedNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_24">209060000</us-gaap:MalpracticeLossContingencyAccrualUndiscountedNoncurrent>
  <us-gaap:OtherAccruedLiabilitiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_1_6">44912000</us-gaap:OtherAccruedLiabilitiesCurrent>
  <us-gaap:OtherAssetsCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_7">17706000</us-gaap:OtherAssetsCurrent>
  <us-gaap:OperatingLeasesFutureMinimumPaymentsDueInThreeYears contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_79071DA6-9EF5-4CBD-9CC3-976A65BE18CC_1001_2">17946000</us-gaap:OperatingLeasesFutureMinimumPaymentsDueInThreeYears>
  <us-gaap:OperatingLeasesFutureMinimumPaymentsDue contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_79071DA6-9EF5-4CBD-9CC3-976A65BE18CC_1001_6">103478000</us-gaap:OperatingLeasesFutureMinimumPaymentsDue>
  <us-gaap:OperatingLeasesFutureMinimumPaymentsDueInTwoYears contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_79071DA6-9EF5-4CBD-9CC3-976A65BE18CC_1001_1">22038000</us-gaap:OperatingLeasesFutureMinimumPaymentsDueInTwoYears>
  <us-gaap:OperatingLossCarryforwards contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_534D1136-F996-4605-A930-CB1498AA2308_1001_0">101900000</us-gaap:OperatingLossCarryforwards>
  <us-gaap:OtherAssetsNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_14">103459000</us-gaap:OtherAssetsNoncurrent>
  <us-gaap:OperatingLeasesFutureMinimumPaymentsDueCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_79071DA6-9EF5-4CBD-9CC3-976A65BE18CC_1001_0">30824000</us-gaap:OperatingLeasesFutureMinimumPaymentsDueCurrent>
  <us-gaap:OperatingLeasesFutureMinimumPaymentsDueInFiveYears contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_79071DA6-9EF5-4CBD-9CC3-976A65BE18CC_1001_4">9440000</us-gaap:OperatingLeasesFutureMinimumPaymentsDueInFiveYears>
  <us-gaap:OperatingLeasesFutureMinimumPaymentsDueInFourYears contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_79071DA6-9EF5-4CBD-9CC3-976A65BE18CC_1001_3">12708000</us-gaap:OperatingLeasesFutureMinimumPaymentsDueInFourYears>
  <us-gaap:PrepaidExpenseCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_6">18763000</us-gaap:PrepaidExpenseCurrent>
  <us-gaap:OtherLiabilitiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_26">32254000</us-gaap:OtherLiabilitiesNoncurrent>
  <us-gaap:PropertyPlantAndEquipmentNet contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_11">133037000</us-gaap:PropertyPlantAndEquipmentNet>
  <us-gaap:PreferredStockParOrStatedValuePerShare contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD_per_shares" decimals="INF" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_31">0.01</us-gaap:PreferredStockParOrStatedValuePerShare>
  <us-gaap:PreferredStockSharesAuthorized contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="shares" decimals="INF" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_32">1000000</us-gaap:PreferredStockSharesAuthorized>
  <us-gaap:PreferredStockValue contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" xsi:nil="true" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_30" />
  <us-gaap:PreferredStockSharesIssued contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="shares" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_33">0</us-gaap:PreferredStockSharesIssued>
  <us-gaap:PropertyPlantAndEquipmentGross contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_BFF7946D-A10A-403B-892A-5D889E0E8A00_1_3">340853000</us-gaap:PropertyPlantAndEquipmentGross>
  <us-gaap:RestrictedCashCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_3">20000000</us-gaap:RestrictedCashCurrent>
  <us-gaap:RetainedEarningsAccumulatedDeficit contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_40">2094359000</us-gaap:RetainedEarningsAccumulatedDeficit>
  <us-gaap:SelfInsuranceReserveCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_609B363D-15A0-4650-B9EC-81F0476B2A5F_1_1">139100000</us-gaap:SelfInsuranceReserveCurrent>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_958A4CD4-6EDD-49A8-968D-37A72B84DCD2_1001_4">54.46</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue>
  <us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1 contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_FAB13649-1F84-4458-B4C6-3E93F4F8FC07_1001_2">700000</us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_7006_900042">3087884000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="shares" decimals="INF" id="id_14062202_AE5979A1-5C5C-4795-B5D0-5850CB9AC220_1001_4">1310853</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="shares" decimals="INF" id="id_14062202_3762BF2C-F2D8-4F6B-B25C-39FCD11E9EE4_1001_3">112976</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_D2B45BBF-A5C6-413E-A194-CDE6AFBFE25D_1001_3">27.65</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="shares" decimals="INF" id="id_14062202_3762BF2C-F2D8-4F6B-B25C-39FCD11E9EE4_1001_2">112976</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_D2B45BBF-A5C6-413E-A194-CDE6AFBFE25D_1001_2">27.65</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice>
  <us-gaap:UnamortizedDebtIssuanceExpense contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_A5B7B805-120B-49EC-B027-5AF8048FDA08_7001_3">19682000</us-gaap:UnamortizedDebtIssuanceExpense>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_FAB13649-1F84-4458-B4C6-3E93F4F8FC07_1001_1">700000</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue>
  <us-gaap:StockholdersEquity contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_41">3087884000</us-gaap:StockholdersEquity>
  <us-gaap:UnrecognizedTaxBenefits contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E1008F61-D7C7-446D-BA10-6A31C276998B_1001_0">11185000</us-gaap:UnrecognizedTaxBenefits>
  <us-gaap:UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_E1008F61-D7C7-446D-BA10-6A31C276998B_1001_1">10900000</us-gaap:UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate>
  <md:AccruedProfessionalLiability contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_609B363D-15A0-4650-B9EC-81F0476B2A5F_1_2">104900000</md:AccruedProfessionalLiability>
  <md:MoneyMarketFundsAtFairValue contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_1EB48F8E-4DC5-41B3-A138-61A50FDB2155_1_0">500000</md:MoneyMarketFundsAtFairValue>
  <md:AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_18">469342000</md:AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent>
  <md:AccruedPayrollTaxesAndBenefitsCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_1_2">80369000</md:AccruedPayrollTaxesAndBenefitsCurrent>
  <md:LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_8AA519C6-33E4-48C5-9F84-04A39653CDFA_1_23">1234780000</md:LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit>
  <md:AccruedContingentConsiderationLiabilityCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6CA26356-2214-408F-9A6B-C1E54AF0988E_1_4">18760000</md:AccruedContingentConsiderationLiabilityCurrent>
  <md:DeferredTaxLiabilitiesChangeInAccountingMethod contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_E6CBECFB-BBE5-458D-A8E3-38ADFF968740_1_11">109418000</md:DeferredTaxLiabilitiesChangeInAccountingMethod>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3064218x3069261_3076363x3258165" unitRef="shares" decimals="-5" id="id_14062202_1912388D-008E-40DF-BD21-3FB677F5C41F_4001_0">2000000</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant>
  <us-gaap:EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3064218x3291163" unitRef="iso4217_USD" decimals="-5" id="id_14062202_73BAE092-579B-4BFA-B702-3EA09F95D8B3_2001_1">30800000</us-gaap:EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions>
  <us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3064719x3302268" unitRef="iso4217_USD" decimals="-5" id="id_14062202_F93F9858-1151-43D2-A889-77EA97D29B6B_2001_2">200000</us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities>
  <us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3064719x3302268" unitRef="iso4217_USD" decimals="-5" id="id_14062202_F93F9858-1151-43D2-A889-77EA97D29B6B_2001_0">1200000</us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets>
  <us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3064719x3302268" unitRef="iso4217_USD" decimals="-5" id="id_14062202_F93F9858-1151-43D2-A889-77EA97D29B6B_2001_1">1500000</us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets>
  <us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3064719x3321594" unitRef="iso4217_USD" decimals="-5" id="id_14062202_220D11CA-8D47-495C-9908-30B86EDD7E63_2001_7">1700000</us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets>
  <us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3064719x3321594" unitRef="iso4217_USD" decimals="-5" id="id_14062202_220D11CA-8D47-495C-9908-30B86EDD7E63_2001_6">17200000</us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles>
  <us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3064719x3321594" unitRef="iso4217_USD" decimals="-5" id="id_14062202_220D11CA-8D47-495C-9908-30B86EDD7E63_2001_8">2100000</us-gaap:BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther>
  <md:DeferredTaxLiabilitiesChangeInAccountingMethod contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3065136x3541682" unitRef="iso4217_USD" decimals="-5" id="id_14062202_CBF6AE6C-F1B7-463C-B899-2D2F890066C2_1001_1">105300000</md:DeferredTaxLiabilitiesChangeInAccountingMethod>
  <us-gaap:LineOfCreditFacilityMaximumBorrowingCapacity contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3073193" unitRef="iso4217_USD" decimals="INF" id="id_14062202_66FDBE91-E4FE-4785-BA00-47E5693D636F_1001_1">37500000</us-gaap:LineOfCreditFacilityMaximumBorrowingCapacity>
  <us-gaap:DebtInstrumentCarryingAmount contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3078864" unitRef="iso4217_USD" decimals="-3" id="id_14062202_898F6FB6-D5D6-4B6A-80FB-E4F8ED9B0C3E_9001_2">739500000</us-gaap:DebtInstrumentCarryingAmount>
  <us-gaap:LongTermDebt contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3078864" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6FC96681-B499-42A4-A974-A7DC2EC1B4AC_9001_2">735226000</us-gaap:LongTermDebt>
  <us-gaap:UnamortizedDebtIssuanceExpense contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3078864" unitRef="iso4217_USD" decimals="-3" id="id_14062202_A5B7B805-120B-49EC-B027-5AF8048FDA08_9001_2">4274000</us-gaap:UnamortizedDebtIssuanceExpense>
  <us-gaap:DebtInstrumentInterestRateStatedPercentage contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3297729" unitRef="pure" decimals="INF" id="id_14062202_642F5DA9-E795-410B-B225-8DD791D3C76E_1001_0">0.0525</us-gaap:DebtInstrumentInterestRateStatedPercentage>
  <us-gaap:DebtInstrumentCarryingAmount contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3297729" unitRef="iso4217_USD" decimals="-3" id="id_14062202_898F6FB6-D5D6-4B6A-80FB-E4F8ED9B0C3E_10001_1">1250000000</us-gaap:DebtInstrumentCarryingAmount>
  <us-gaap:LongTermDebt contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3297729" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6FC96681-B499-42A4-A974-A7DC2EC1B4AC_10001_1">1234592000</us-gaap:LongTermDebt>
  <us-gaap:UnamortizedDebtIssuanceExpense contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3297729" unitRef="iso4217_USD" decimals="-3" id="id_14062202_A5B7B805-120B-49EC-B027-5AF8048FDA08_10001_1">15408000</us-gaap:UnamortizedDebtIssuanceExpense>
  <us-gaap:NotesPayableFairValueDisclosure contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3297729_3068684x3070091_3070058x3068644" unitRef="iso4217_USD" decimals="-3" id="id_14062202_56503278-D8FE-4DEA-AFB7-67FCF25A3F6B_1001_0">736725000</us-gaap:NotesPayableFairValueDisclosure>
  <us-gaap:LineOfCreditFacilityMaximumBorrowingCapacity contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3336802" unitRef="iso4217_USD" decimals="INF" id="id_14062202_66FDBE91-E4FE-4785-BA00-47E5693D636F_2001_0">2000000000</us-gaap:LineOfCreditFacilityMaximumBorrowingCapacity>
  <us-gaap:DebtInstrumentInterestRateStatedPercentage contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3538202" unitRef="pure" decimals="INF" id="id_14062202_642F5DA9-E795-410B-B225-8DD791D3C76E_2001_1">0.0625</us-gaap:DebtInstrumentInterestRateStatedPercentage>
  <us-gaap:NotesPayableFairValueDisclosure contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3538202_3068684x3070091_3070058x3068644" unitRef="iso4217_USD" decimals="-3" id="id_14062202_56503278-D8FE-4DEA-AFB7-67FCF25A3F6B_2001_1">482500000</us-gaap:NotesPayableFairValueDisclosure>
  <us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3066421" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1002_2">71870000</us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization>
  <us-gaap:FiniteLivedIntangibleAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3066421" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1002_1">443300000</us-gaap:FiniteLivedIntangibleAssetsGross>
  <us-gaap:FiniteLivedIntangibleAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3066421" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1002_3">371430000</us-gaap:FiniteLivedIntangibleAssetsNet>
  <us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3081468" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1003_2">4630000</us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization>
  <us-gaap:FiniteLivedIntangibleAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3081468" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1003_1">43156000</us-gaap:FiniteLivedIntangibleAssetsGross>
  <us-gaap:FiniteLivedIntangibleAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3081468" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1003_3">38526000</us-gaap:FiniteLivedIntangibleAssetsNet>
  <us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3253046" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1004_2">22487000</us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization>
  <us-gaap:FiniteLivedIntangibleAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3253046" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1004_1">47561000</us-gaap:FiniteLivedIntangibleAssetsGross>
  <us-gaap:FiniteLivedIntangibleAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3253046" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1004_3">25074000</us-gaap:FiniteLivedIntangibleAssetsNet>
  <us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3294255" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1001_2">223589000</us-gaap:FiniteLivedIntangibleAssetsAccumulatedAmortization>
  <us-gaap:FiniteLivedIntangibleAssetsGross contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3294255" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1001_1">376871000</us-gaap:FiniteLivedIntangibleAssetsGross>
  <us-gaap:FiniteLivedIntangibleAssetsNet contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3294255" unitRef="iso4217_USD" decimals="-3" id="id_14062202_DDFE3CD3-DF60-4AF5-B376-70933C31478C_1001_3">153282000</us-gaap:FiniteLivedIntangibleAssetsNet>
  <us-gaap:HeldToMaturitySecuritiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3073527x3065535" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_2003_1">1450000</us-gaap:HeldToMaturitySecuritiesCurrent>
  <us-gaap:HeldToMaturitySecuritiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3073527x3065535" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_2003_2">4465000</us-gaap:HeldToMaturitySecuritiesNoncurrent>
  <us-gaap:HeldToMaturitySecuritiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3073527x3081528" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_2002_1">2000000</us-gaap:HeldToMaturitySecuritiesCurrent>
  <us-gaap:HeldToMaturitySecuritiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3073527x3081528" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_2002_2">34393000</us-gaap:HeldToMaturitySecuritiesNoncurrent>
  <us-gaap:HeldToMaturitySecuritiesCurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3073527x3081530" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_2001_1">18473000</us-gaap:HeldToMaturitySecuritiesCurrent>
  <us-gaap:HeldToMaturitySecuritiesNoncurrent contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3073527x3081530" unitRef="iso4217_USD" decimals="-3" id="id_14062202_17B7F70B-B9C4-4CE7-A637-4F3079400279_2001_2">30841000</us-gaap:HeldToMaturitySecuritiesNoncurrent>
  <us-gaap:CommonStockSharesAuthorized contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3076363x3384934" unitRef="shares" decimals="INF" id="id_14062202_25C8A35A-F4B1-4F0E-BD5C-BCDD3F94FBF3_2001_0">2600000</us-gaap:CommonStockSharesAuthorized>
  <us-gaap:CommonStockCapitalSharesReservedForFutureIssuance contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3076363x3384934" unitRef="shares" decimals="-5" id="id_14062202_25C8A35A-F4B1-4F0E-BD5C-BCDD3F94FBF3_2001_2">1600000</us-gaap:CommonStockCapitalSharesReservedForFutureIssuance>
  <us-gaap:AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3078429x3252751" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5AB7E65F-6B18-4C0B-979C-191C7614027B_1001_1">4000000</us-gaap:AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment>
  <us-gaap:PropertyPlantAndEquipmentGross contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3078429x3252751" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5AB7E65F-6B18-4C0B-979C-191C7614027B_1001_0">4800000</us-gaap:PropertyPlantAndEquipmentGross>
  <us-gaap:EquityMethodInvestmentOwnershipPercentage contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3079978x3295964" unitRef="pure" decimals="3" id="id_14062202_0C99C5A3-919E-4E6A-A981-806624504C29_1001_0">0.375</us-gaap:EquityMethodInvestmentOwnershipPercentage>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_7003_600042">992647000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_7001_500042">878000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:SharesIssued contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_7001_400043">87820000</us-gaap:SharesIssued>
  <us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3080925x3078149" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_7004_700042">2094359000</us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest>
  <us-gaap:Goodwill contextRef="eol_PE10840---1810-K0015_STD_0_20181231_0_3081292x3281103" unitRef="iso4217_USD" decimals="-5" id="id_14062202_A535C8EC-58AF-4A1D-8025-798E5ED8C7A5_1001_0">321600000</us-gaap:Goodwill>
  <md:DeconsolidationPercentage contextRef="eol_PE10840---1810-K0015_STD_1_20170331_0" unitRef="pure" decimals="INF" id="id_14062202_A6732596-C0D8-4D3B-A695-75E1461DF023_1_1">1.00</md:DeconsolidationPercentage>
  <md:SaleOfMinorityInterestPercentage contextRef="eol_PE10840---1810-K0015_STD_1_20170331_0" unitRef="pure" decimals="2" id="id_14062202_A6732596-C0D8-4D3B-A695-75E1461DF023_1_0">0.75</md:SaleOfMinorityInterestPercentage>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_1_20180904_0_3081082x3275817" unitRef="iso4217_USD" decimals="-5" id="id_14062202_4A9B4BE2-A296-40A0-A94F-0FF2B3076A33_1002_1">250000000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:StockRepurchasedDuringPeriodShares contextRef="eol_PE10840---1810-K0015_STD_1_20180904_0_3081082x3275817" unitRef="shares" decimals="-5" id="id_14062202_4A9B4BE2-A296-40A0-A94F-0FF2B3076A33_1002_2">4200000</us-gaap:StockRepurchasedDuringPeriodShares>
  <us-gaap:StockRepurchasedDuringPeriodShares contextRef="eol_PE10840---1810-K0015_STD_31_20181231_0_3081082x3275817" unitRef="shares" decimals="-5" id="id_14062202_4A9B4BE2-A296-40A0-A94F-0FF2B3076A33_1003_2">1700000</us-gaap:StockRepurchasedDuringPeriodShares>
  <us-gaap:AllocatedShareBasedCompensationExpense contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5DD587BB-0B66-4963-A269-D923B9E5F198_2_0">29600000</us-gaap:AllocatedShareBasedCompensationExpense>
  <us-gaap:AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="shares" decimals="-3" id="id_14062202_5D948726-9D47-457B-BD6D-63332D0C9B24_2_3">107000</us-gaap:AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount>
  <us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6006_900023">29573000</us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue>
  <us-gaap:AmortizationOfFinancingCostsAndDiscounts contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_4">5514000</us-gaap:AmortizationOfFinancingCostsAndDiscounts>
  <us-gaap:AmortizationOfIntangibleAssets contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_23B92773-CA4C-435B-A91C-A85F548D9201_2_0">68900000</us-gaap:AmortizationOfIntangibleAssets>
  <us-gaap:CapitalExpendituresIncurredButNotYetPaid contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_48">2700000</us-gaap:CapitalExpendituresIncurredButNotYetPaid>
  <us-gaap:CapitalLeaseObligationsIncurred contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_47">684000</us-gaap:CapitalLeaseObligationsIncurred>
  <us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_38">24502000</us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect>
  <us-gaap:CurrentFederalTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_2_0">130053000</us-gaap:CurrentFederalTaxExpenseBenefit>
  <us-gaap:CurrentStateAndLocalTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_2_3">20070000</us-gaap:CurrentStateAndLocalTaxExpenseBenefit>
  <us-gaap:DeferredFederalIncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_2_1">-63038000</us-gaap:DeferredFederalIncomeTaxExpenseBenefit>
  <us-gaap:DeferredIncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_6">-60073000</us-gaap:DeferredIncomeTaxExpenseBenefit>
  <us-gaap:DeferredStateAndLocalIncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_2_4">2965000</us-gaap:DeferredStateAndLocalIncomeTaxExpenseBenefit>
  <us-gaap:Depreciation contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5AB7E65F-6B18-4C0B-979C-191C7614027B_2_2">33900000</us-gaap:Depreciation>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_5">102879000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:DefinedContributionPlanCostRecognized contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_99CF5A6E-BE3D-4251-BDB1-4F0036EE4DA6_2_0">50700000</us-gaap:DefinedContributionPlanCostRecognized>
  <us-gaap:EffectiveIncomeTaxRateContinuingOperations contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_14062202_825CA47E-8C6C-4752-B30C-4D0591235E93_2_1">0.2194</us-gaap:EffectiveIncomeTaxRateContinuingOperations>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_19">3.45</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="pure" decimals="INF" id="id_14062202_825CA47E-8C6C-4752-B30C-4D0591235E93_2_0">0.350</us-gaap:EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate>
  <us-gaap:EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_2_5">0.0016</us-gaap:EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent>
  <us-gaap:EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_2_1">0.0333</us-gaap:EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_18">3.47</us-gaap:EarningsPerShareBasic>
  <us-gaap:EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_2_6">-0.1706</us-gaap:EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate>
  <us-gaap:EffectiveIncomeTaxRateReconciliationNondeductibleExpense contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_2_2">0.0049</us-gaap:EffectiveIncomeTaxRateReconciliationNondeductibleExpense>
  <us-gaap:EffectiveIncomeTaxRateReconciliationOtherAdjustments contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_2_3">0.0002</us-gaap:EffectiveIncomeTaxRateReconciliationOtherAdjustments>
  <us-gaap:FederalIncomeTaxExpenseBenefitContinuingOperations contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_2_2">67015000</us-gaap:FederalIncomeTaxExpenseBenefitContinuingOperations>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_4">417105000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_12">410422000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_10">952000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_13">90050000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_15">18478000</us-gaap:IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve>
  <us-gaap:IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_10">2792000</us-gaap:IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets>
  <us-gaap:IncomeTaxesPaidNet contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_44">75427000</us-gaap:IncomeTaxesPaidNet>
  <us-gaap:IncreaseDecreaseInAccountsPayableAndAccruedLiabilities contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_12">24551000</us-gaap:IncreaseDecreaseInAccountsPayableAndAccruedLiabilities>
  <us-gaap:IncreaseDecreaseInAccruedIncomeTaxesPayable contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_13">73050000</us-gaap:IncreaseDecreaseInAccruedIncomeTaxesPayable>
  <us-gaap:IncreaseDecreaseInOtherNoncurrentAssets contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_11">2709000</us-gaap:IncreaseDecreaseInOtherNoncurrentAssets>
  <us-gaap:IncreaseDecreaseInAccountsReceivable contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_9">-7803000</us-gaap:IncreaseDecreaseInAccountsReceivable>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_9">74559000</us-gaap:InterestExpense>
  <us-gaap:IncreaseDecreaseInOtherOperatingLiabilities contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_16">-735000</us-gaap:IncreaseDecreaseInOtherOperatingLiabilities>
  <us-gaap:IncrementalCommonSharesAttributableToShareBasedPaymentArrangements contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="shares" decimals="-3" id="id_14062202_5D948726-9D47-457B-BD6D-63332D0C9B24_2_1">527000</us-gaap:IncrementalCommonSharesAttributableToShareBasedPaymentArrangements>
  <us-gaap:InterestPaidNet contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_43">73837000</us-gaap:InterestPaidNet>
  <us-gaap:InvestmentIncomeNet contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_8">3953000</us-gaap:InvestmentIncomeNet>
  <us-gaap:LeaseAndRentalExpense contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_EE3DBF28-717E-4E17-B56B-93BBC8045234_2_0">42600000</us-gaap:LeaseAndRentalExpense>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredNet contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_2_7">23855000</us-gaap:MalpracticeLossContingencyClaimsIncurredNet>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_11">-69654000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredInPeriod contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_2_5">712000</us-gaap:MalpracticeLossContingencyClaimsIncurredInPeriod>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredInPriorPeriods contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_2_6">23143000</us-gaap:MalpracticeLossContingencyClaimsIncurredInPriorPeriods>
  <us-gaap:NetCashProvidedByUsedInInvestingActivities contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_25">-576613000</us-gaap:NetCashProvidedByUsedInInvestingActivities>
  <us-gaap:NetCashProvidedByUsedInFinancingActivities contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_37">89737000</us-gaap:NetCashProvidedByUsedInFinancingActivities>
  <us-gaap:NetCashProvidedByUsedInOperatingActivities contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_17">511378000</us-gaap:NetCashProvidedByUsedInOperatingActivities>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_16">320372000</us-gaap:NetIncomeLoss>
  <us-gaap:OtherNoncashIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_7">3783000</us-gaap:OtherNoncashIncomeExpense>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_6">2978236000</us-gaap:OperatingExpenses>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_7">480076000</us-gaap:OperatingIncomeLoss>
  <us-gaap:PaymentsOfFinancingCosts contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_30">3525000</us-gaap:PaymentsOfFinancingCosts>
  <us-gaap:PaymentsToAcquireInvestments contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_20">27723000</us-gaap:PaymentsToAcquireInvestments>
  <us-gaap:PaymentsToAcquireOtherPropertyPlantAndEquipment contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_22">49309000</us-gaap:PaymentsToAcquireOtherPropertyPlantAndEquipment>
  <us-gaap:PaymentsForRepurchaseOfCommonStock contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_36">70192000</us-gaap:PaymentsForRepurchaseOfCommonStock>
  <us-gaap:PaymentsToAcquireBusinessesNetOfCashAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_19">531696000</us-gaap:PaymentsToAcquireBusinessesNetOfCashAcquired>
  <us-gaap:PaymentForContingentConsiderationLiabilityFinancingActivities contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_31">5449000</us-gaap:PaymentForContingentConsiderationLiabilityFinancingActivities>
  <us-gaap:PaymentForContingentConsiderationLiabilityOperatingActivities contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_14">750000</us-gaap:PaymentForContingentConsiderationLiabilityOperatingActivities>
  <us-gaap:PaymentsForProceedsFromOtherInvestingActivities contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_24">-6705000</us-gaap:PaymentsForProceedsFromOtherInvestingActivities>
  <us-gaap:ProceedsFromIssuanceOfCommonStock contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_34">23276000</us-gaap:ProceedsFromIssuanceOfCommonStock>
  <us-gaap:ProceedsFromMinorityShareholders contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_35">894000</us-gaap:ProceedsFromMinorityShareholders>
  <us-gaap:ProceedsFromSaleMaturityAndCollectionsOfInvestments contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_21">25410000</us-gaap:ProceedsFromSaleMaturityAndCollectionsOfInvestments>
  <us-gaap:ProceedsAndExcessTaxBenefitFromSharebasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_6F395465-392B-4EF7-A44E-32EB382B7841_2_1">4800000</us-gaap:ProceedsAndExcessTaxBenefitFromSharebasedCompensation>
  <us-gaap:ProceedsFromLinesOfCredit contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_27">2846000000</us-gaap:ProceedsFromLinesOfCredit>
  <us-gaap:RepaymentsOfLinesOfCredit contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_28">2699000000</us-gaap:RepaymentsOfLinesOfCredit>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_14">320372000</us-gaap:ProfitLoss>
  <us-gaap:RepaymentsOfLongTermCapitalLeaseObligations contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_32">2267000</us-gaap:RepaymentsOfLongTermCapitalLeaseObligations>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_0">3458312000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:ShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_5">29573000</us-gaap:ShareBasedCompensation>
  <us-gaap:StockIssued1 contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_2_46">2657000</us-gaap:StockIssued1>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5080F253-A8E3-4227-B70D-A0CAED6DE09C_2_0">29300000</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_9CB6A509-EAD0-4AB1-AFD9-A8157CACD7B4_2_0">54.22</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_0BEDD904-2C88-4DA8-A32F-9B4E71FC7DFB_2_0">5500000</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue>
  <us-gaap:StateAndLocalIncomeTaxExpenseBenefitContinuingOperations contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_2_5">23035000</us-gaap:StateAndLocalIncomeTaxExpenseBenefitContinuingOperations>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6006_900026">70192000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6006_900017">23276000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation>
  <us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_2_1">2284000</us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions>
  <us-gaap:UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_2_5">2068000</us-gaap:UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="shares" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_22">92958000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="shares" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_21">92431000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_2_3">1430000</us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions>
  <us-gaap:UnrecognizedTaxBenefitsPeriodIncreaseDecrease contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_6AB14061-8583-435A-96D0-284EFC33E3CD_2_0">1500000</us-gaap:UnrecognizedTaxBenefitsPeriodIncreaseDecrease>
  <us-gaap:UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_2_2">143000</us-gaap:UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions>
  <md:AccruedProfessionalLiabilitiesAssumedThroughAcquisition contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_2_1">20716000</md:AccruedProfessionalLiabilitiesAssumedThroughAcquisition>
  <md:IncomeTaxExpenseForExcessTaxDeficiencies contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_98BCFEDA-A07E-4A42-AD88-CDB7C51CB46B_2_1">200000</md:IncomeTaxExpenseForExcessTaxDeficiencies>
  <md:ProvisionAdjustmentForLossesRelatedToPriorYear contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_2_3">9983000</md:ProvisionAdjustmentForLossesRelatedToPriorYear>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_3">120518000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:MalpracticeLossContingencyProvisionForLosses contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_2_4">51274000</md:MalpracticeLossContingencyProvisionForLosses>
  <md:ProvisionAdjustmentForLossesRelatedToCurrentYear contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_2_2">41291000</md:ProvisionAdjustmentForLossesRelatedToCurrentYear>
  <md:StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6006_900021">2658000</md:StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_2_2">2337734000</md:PracticeSalariesAndBenefits>
  <md:NumberOfPediatricMultiSpecialtyPracticesAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_14062202_10947C2A-3950-4E3C-B4B2-166DF5ECD06E_1_4">1</md:NumberOfPediatricMultiSpecialtyPracticesAcquired>
  <md:NumberOfPhysicianGroupPracticesAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_14062202_10947C2A-3950-4E3C-B4B2-166DF5ECD06E_1_0">10</md:NumberOfPhysicianGroupPracticesAcquired>
  <md:NumberOfMaternalfetalMedicinePracticesAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_14062202_10947C2A-3950-4E3C-B4B2-166DF5ECD06E_1_2">2</md:NumberOfMaternalfetalMedicinePracticesAcquired>
  <md:NumberOfPediatricSubspecialtyPracticesAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_14062202_10947C2A-3950-4E3C-B4B2-166DF5ECD06E_1_3">2</md:NumberOfPediatricSubspecialtyPracticesAcquired>
  <md:NumberOfRadiologyPracticesAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_14062202_10947C2A-3950-4E3C-B4B2-166DF5ECD06E_1_5">4</md:NumberOfRadiologyPracticesAcquired>
  <md:NumberOfNeonatologyPracticesAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="Company" decimals="INF" id="id_14062202_10947C2A-3950-4E3C-B4B2-166DF5ECD06E_1_1">1</md:NumberOfNeonatologyPracticesAcquired>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_2_4">1.00</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <us-gaap:AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3064218x3079518" unitRef="iso4217_USD" decimals="-5" id="id_14062202_2913A790-0530-4BE1-B85C-5ADE09B19D0A_1001_3">2100000</us-gaap:AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation>
  <us-gaap:SharesPaidForTaxWithholdingForShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3064218x3079518" unitRef="shares" decimals="0" id="id_14062202_2913A790-0530-4BE1-B85C-5ADE09B19D0A_1001_2">38257</us-gaap:SharesPaidForTaxWithholdingForShareBasedCompensation>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3063975_3065618x3071754" unitRef="pure" decimals="2" id="id_14062202_B11296A4-C34A-4A53-A695-71FB262F71D8_1002_0">0.17</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245" unitRef="pure" decimals="INF" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_1002_6">1.00</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3073813" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_2002_4">0.06</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3245705" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_3002_2">0.08</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3253054" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_4002_0">0.37</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3253055" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_5002_1">0.38</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3253056" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_6002_3">0.08</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3317063" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_7002_5">0.03</us-gaap:ConcentrationRiskPercentage1>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3071347x3071755" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_1002_1">0.25</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3071347x3080487" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_2002_3">0.01</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3071347x3081046" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_3002_2">0.04</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3071347x3281104" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_4002_0">0.70</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3077210x3071532" unitRef="iso4217_USD" decimals="-3" id="id_14062202_04DF90CB-17A0-49B6-80F6-CCFE1209913A_1002_1">2915648000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3077210x3073813" unitRef="iso4217_USD" decimals="-3" id="id_14062202_04DF90CB-17A0-49B6-80F6-CCFE1209913A_2002_3">226886000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3077210x3296576" unitRef="iso4217_USD" decimals="-3" id="id_14062202_04DF90CB-17A0-49B6-80F6-CCFE1209913A_3002_2">315778000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3078734x3268616" unitRef="iso4217_USD" decimals="-5" id="id_14062202_6C8DDD61-305F-4BD0-A872-046929E36F97_1001_0">200000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6003_600023">29573000</us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6003_600019">-5000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6003_600026">12473000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6003_600024">-1000</us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6003_600017">23271000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation>
  <md:StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6003_600021">2657000</md:StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration>
  <us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensationGross contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6001_400020">536000</us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensationGross>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6001_500019">5000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6001_500026">10000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6001_400025">92000</us-gaap:StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited>
  <us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6001_400018">528000</us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensation>
  <us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6001_500024">1000</us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6001_500017">5000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation>
  <us-gaap:StockRepurchasedDuringPeriodShares contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6001_400027">1038000</us-gaap:StockRepurchasedDuringPeriodShares>
  <md:StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6001_500021">1000</md:StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration>
  <md:StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6001_400022">69000</md:StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3078149" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6004_700016">320372000</us-gaap:ProfitLoss>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3078149" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_6004_700026">57709000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:OpenTaxYear contextRef="eol_PE10840---1810-K0015_STD_365_20171231_0_3081022x3073129" id="id_14062202_04F47F65-900D-4C1E-8CF1-25F398703974_2_0">2017</us-gaap:OpenTaxYear>
  <us-gaap:AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_51CB6CBA-A180-4E5B-A51B-BDF704D0B738_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;8.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Accounts Payable and Accrued
 Expenses:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Accounts payable and accrued expenses consist of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="70%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;31,059&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;34,632&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;249,834&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;225,429&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;80,369&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;75,672&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;34,931&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;37,912&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;18,760&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6,259&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;9,477&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;4,495&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;44,912&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;53,618&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;469,342&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;438,017&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock>
  <us-gaap:AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="INF" id="id_14062202_6F395465-392B-4EF7-A44E-32EB382B7841_1_2">0</us-gaap:AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation>
  <us-gaap:AllocatedShareBasedCompensationExpense contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5DD587BB-0B66-4963-A269-D923B9E5F198_1_0">38700000</us-gaap:AllocatedShareBasedCompensationExpense>
  <us-gaap:AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="shares" decimals="-3" id="id_14062202_5D948726-9D47-457B-BD6D-63332D0C9B24_1_3">214000</us-gaap:AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount>
  <dei:AmendmentFlag contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_34DAAF8E-0206-4455-816A-0C734573D691_1_1">false</dei:AmendmentFlag>
  <us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9006_900035">38703000</us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue>
  <us-gaap:AmortizationOfFinancingCostsAndDiscounts contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_4">4572000</us-gaap:AmortizationOfFinancingCostsAndDiscounts>
  <us-gaap:AmortizationOfIntangibleAssets contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_23B92773-CA4C-435B-A91C-A85F548D9201_1_0">72800000</us-gaap:AmortizationOfIntangibleAssets>
  <us-gaap:BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_4E821083-0981-419D-A879-1B645A1175E9_1_2">-5300000</us-gaap:BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1>
  <us-gaap:CapitalExpendituresIncurredButNotYetPaid contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_48">2927000</us-gaap:CapitalExpendituresIncurredButNotYetPaid>
  <us-gaap:BusinessCombinationsPolicy contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_B78248F1-8FDC-4BD3-AE5C-A6682FB7DB0A_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Business Acquisitions&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company accounts for all business acquisitions at fair value
 and expenses acquisition costs as they are incurred. Any
 identifiable assets acquired and liabilities assumed are recognized
 and measured at their respective fair values on the acquisition
 date. If information about facts and circumstances existing as of
 the acquisition date is incomplete at the end of the reporting
 period in which a business acquisition occurs, the Company will
 report provisional amounts for the items for which the accounting
 is incomplete. The measurement period ends once the Company
 receives sufficient information to finalize the fair values;
 however, the period will not exceed one year from the acquisition
 date. Any adjustments to provisional amounts that are identified
 during the measurement period are recognized in the reporting
 period in which the adjustment amounts are determined.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 In connection with certain acquisitions, the Company enters into
 agreements to pay additional amounts in cash or common stock based
 on the achievement of certain performance measures for up to five
 years ending after the acquisition dates. The Company measures this
 contingent consideration at fair value at the acquisition date and
 records such contingent consideration as a liability or equity on
 the Company&amp;#x2019;s Consolidated Balance Sheets on the acquisition
 date. The fair value of each contingent consideration liability is
 remeasured at each reporting period with any change in fair value
 recognized as income or expense within operations in the
 Company&amp;#x2019;s Consolidated Statements of Income. See Note 6 for
 more information on the Company&amp;#x2019;s business acquisitions.&lt;/p&gt;


 &lt;/div&gt;</us-gaap:BusinessCombinationsPolicy>
  <us-gaap:BusinessCombinationConsiderationTransferred1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_220D11CA-8D47-495C-9908-30B86EDD7E63_1_4">111800000</us-gaap:BusinessCombinationConsiderationTransferred1>
  <us-gaap:BusinessCombinationDisclosureTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_30FFE769-1010-45C7-A357-AE97DF182952_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;6.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Business Acquisitions:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 During the year ended December&amp;#xA0;31, 2018, the Company completed
 nine physician group practice acquisitions, including five
 radiology practices, two neonatology practices and two other
 pediatric subspecialty practices. The acquisition-date fair value
 of the total consideration for the nine acquisitions was
 $111.8&amp;#xA0;million, net of cash acquired. In connection with these
 acquisitions, the Company recorded goodwill of $95.0&amp;#xA0;million,
 other intangible assets consisting primarily of physician and
 hospital agreements of $17.2&amp;#xA0;million, current assets of
 $1.7&amp;#xA0;million and other liabilities of $2.1&amp;#xA0;million.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 These acquisitions expanded the Company&amp;#x2019;s national network of
 physician practices. The Company expects to improve the results of
 physician practices through improved managed care contracting,
 improved collections and identification of growth initiatives, as
 well as operating and cost savings based on the significant
 infrastructure it has developed. With respect to the
 Company&amp;#x2019;s acquisition of radiology physician practices, the
 Company believes that it brings a unique value proposition to
 radiology physician groups, in that the Company can provide
 practice management support and a technology platform enabling
 radiology to be practiced at a national level, as well as
 teleradiology capabilities that can enhance a physician
 group&amp;#x2019;s efficiency, provide subspecialty access and help them
 to grow strategically and remain competitive while meeting the
 demands of their hospital partners, third-party payors and
 regulatory bodies. In addition, the Company believes that radiology
 physician group practice physicians can complement the staffing
 needs for its teleradiology services business during certain times,
 such as nights and weekends, when such physicians are not providing
 services at their practices.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 During the year ended December&amp;#xA0;31, 2018, in connection with
 certain prior-period acquisitions, the Company paid
 $6.4&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. Of these amounts,
 all except for the accretion recorded during 2018 were accrued as
 of December&amp;#xA0;31, 2017. In addition, the Company recorded a
 decrease of $5.3&amp;#xA0;million related to the change in the fair
 value of a contingent consideration agreement for which the
 probability of the achievement of certain performance measures was
 updated. This change in fair value of contingent consideration was
 recorded within operating expenses.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 In connection with certain prior-period acquisitions, the Company
 also recorded a net increase in goodwill of $4.0&amp;#xA0;million
 composed of a decrease in current assets of $1.2&amp;#xA0;million, a
 decrease in noncurrent assets of $1.5&amp;#xA0;million and a decrease
 in liabilities of $0.2&amp;#xA0;million for measurement-period
 adjustments resulting from the finalization of acquisition
 accounting as well as additional cash consideration of
 $1.5&amp;#xA0;million related to a working capital true up.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 On November&amp;#xA0;1, 2018, the Company announced the initiation of a
 process to potentially divest the Company&amp;#x2019;s management
 services service line to allow the Company to focus the
 organization on its core physician services business. There can be
 no assurance that this process will result in a transaction, and
 the Company may decide to retain all or part of the management
 services service line. The Company had expected that the management
 services service line could be classified as assets and liabilities
 held for sale within the Company&amp;#x2019;s Consolidated Balance
 Sheets and that historical operating results of the service line
 could be reported as discontinued operations in the Company&amp;#x2019;s
 Consolidated Statements of Income for the year ended
 December&amp;#xA0;31, 2018; however, the criteria for such
 classification was not met at December&amp;#xA0;31, 2018. The
 management services service line continues to be classified as held
 and used as of December&amp;#xA0;31, 2018.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 During the year ended December&amp;#xA0;31, 2017, the Company completed
 10 physician group practice acquisitions, including four radiology
 practices, two maternal-fetal medicine practices, one neonatology
 practice, one pediatric multi-specialty practice and two other
 pediatric subspecialty practices.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 On March&amp;#xA0;31, 2017, the Company sold its 75% economic interest
 in a joint venture that was previously consolidated. The
 deconsolidation and removal of 100% of the carrying value of the
 joint venture&amp;#x2019;s net assets resulted in a gain on sale that
 was not material.&lt;/p&gt;


 &lt;/div&gt;</us-gaap:BusinessCombinationDisclosureTextBlock>
  <us-gaap:CashAndCashEquivalentsPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_778AB7A5-BC30-45C3-8486-34C0798852BE_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Cash and Cash Equivalents&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Cash equivalents are defined as all highly liquid financial
 instruments with maturities of 90 days or less from the date of
 purchase. The Company&amp;#x2019;s cash equivalents typically consist of
 demand deposits, amounts on deposit in money market accounts, and
 funds invested in overnight repurchase agreements. Cash equivalent
 balances may, at certain times, exceed federally insured
 limits.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 Certain cash equivalents carried by the Company are subject to the
 fair value provisions of the accounting guidance for fair value
 measurements. See &amp;#x201C;Fair Value Measurements&amp;#x201D; below.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:CashAndCashEquivalentsPolicyTextBlock>
  <us-gaap:CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_D3C01F32-A423-4C0B-9D78-DB3E98996127_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Restricted Cash&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Restricted cash consists of funds in escrow related to a potential
 future payment for contingent consideration for an acquisition
 completed in 2017.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy>
  <us-gaap:CommitmentsAndContingenciesDisclosureTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_C10E5086-A936-49A9-B145-9BC2EFD7E906_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;16. &amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Commitments and
 Contingencies:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&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 December&amp;#xA0;31, 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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&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;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company leases space for its regional, medical and business
 offices, storage space and temporary housing of medical staff. The
 Company also leases an aircraft. Rent expense for the years ended
 December&amp;#xA0;31, 2018, 2017 and 2016 was $42.9&amp;#xA0;million,
 $42.6&amp;#xA0;million and $38.0&amp;#xA0;million, respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Future minimum lease payments under&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-cancelable&lt;/font&gt;&amp;#xA0;operating
 leases as of December&amp;#xA0;31, 2018 are as follows (in
 thousands):&lt;b&gt;&amp;#xA0;&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="83%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2019&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,824&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2020&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;22,038&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2021&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;17,946&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2022&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;12,708&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2023&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;9,440&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Thereafter&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,522&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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;103,478&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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</us-gaap:CommitmentsAndContingenciesDisclosureTextBlock>
  <us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_38">-23455000</us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect>
  <us-gaap:DebtAndCapitalLeasesDisclosuresTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_C48BF37F-AD03-4070-A123-1CC394988A0F_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;10.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Line of Credit, Long-Term Debt and
 Capital Lease Obligations:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company&amp;#x2019;s Credit Agreement provides for a
 $2.0&amp;#xA0;billion unsecured revolving credit facility and includes
 a $37.5&amp;#xA0;million&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;sub-facility&lt;/font&gt;&amp;#xA0;for the
 issuance of letters of credit. In November 2018, the Company
 amended and restated its Credit Agreement to make certain
 technical, conforming and other changes. The Credit Agreement
 matures on October&amp;#xA0;31, 2022 and is guaranteed by substantially
 all of the Company&amp;#x2019;s subsidiaries and affiliated professional
 associations and corporations. At the Company&amp;#x2019;s option,
 borrowings under the Credit Agreement will bear interest at
 (i)&amp;#xA0;the alternate base rate (defined as the higher of
 (a)&amp;#xA0;the prime rate, (b)&amp;#xA0;the Federal Funds Rate plus 1/2
 of 1.00% and (c)&amp;#xA0;LIBOR for an interest period of one month
 plus 1.00%) plus an applicable margin rate ranging from 0.125% to
 0.750% based on the Company&amp;#x2019;s consolidated leverage ratio or
 (ii)&amp;#xA0;the LIBOR rate plus an applicable margin rate ranging
 from 1.125% to 1.750% based on the Company&amp;#x2019;s consolidated
 leverage ratio. The Credit Agreement also calls for other customary
 fees and charges, including an unused commitment fee ranging from
 0.150% to 0.300% of the unused lending commitments, based on the
 Company&amp;#x2019;s consolidated leverage ratio.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Credit Agreement contains customary covenants and restrictions,
 including covenants that require the Company to maintain a minimum
 interest charge ratio, not to exceed a specified consolidated
 leverage ratio and to comply with laws, and restrictions on the
 ability of the Company to pay dividends and make certain other
 distributions, as specified therein. Failure to comply with these
 covenants would constitute an event of default under the 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.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 In December 2015, the Company completed a private offering of
 $750.0&amp;#xA0;million aggregate principal amount of 2023 Notes. In
 November 2018, the Company completed a private offering of
 $500.0&amp;#xA0;million aggregate principal amount of 2027 Notes. The
 Company&amp;#x2019;s obligations under the 2023 Notes and the 2027 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 Notes accrues at the
 rate of 5.25% per annum and is payable semi-annually in arrears on
 June&amp;#xA0;1 and December 1. Interest on the 2027 Notes accrues at
 the rate of 6.25% per annum and is payable semi-annually in arrears
 on January&amp;#xA0;15 and July&amp;#xA0;15, with the initial interest
 payment due on January&amp;#xA0;15, 2019.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 As of December&amp;#xA0;31, 2018, the Company may redeem all or a
 portion of the 2023 Notes, at the redemption prices of 102.625% in
 2019, 101.313% in 2020 and 100% in 2021 and thereafter, plus
 accrued and unpaid interest to the redemption date.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 At any time prior to January&amp;#xA0;15, 2022, the Company may redeem
 all or a portion of the 2027 Notes at a redemption price equal to
 100% of the principal amount of the notes being redeemed plus an
 applicable redemption premium and accrued and unpaid interest to
 the redemption date. In addition, at any time prior to
 January&amp;#xA0;15, 2022, the Company may redeem up to 35% of the
 aggregate principal amount of the 2027 Notes at a redemption price
 of 106.250% of the principal amount thereof, plus accrued and
 unpaid interest, if any, to the redemption date, using proceeds
 from one or more equity offerings. On or after January&amp;#xA0;15,
 2022, the Company may redeem all or a portion of the 2027 Notes, at
 the redemption prices of 104.688% in 2022, 103.125% in 2023,
 101.563% in 2024 and 100% in 2025 and thereafter, plus accrued and
 unpaid interest to the redemption date.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The indenture under which the 2023 Notes and the 2027 Notes are
 issued, among other things, limits our ability to (1)&amp;#xA0;incur
 liens and (2)&amp;#xA0;enter into sale and lease-back transactions, and
 also limits our ability to merge or dispose of all or substantially
 all of our assets, in all cases, subject to a number of customary
 exceptions. Although we are not required to make mandatory
 redemption or sinking fund payments with respect to the 2023 Notes
 or the 2027 Notes, upon the occurrence of a change in control of
 MEDNAX, we may be required to repurchase the 2023 Notes or the 2027
 Notes at a purchase price equal to 101% of the aggregate principal
 amount of the 2023 Notes and the 2027 Notes repurchased plus
 accrued and unpaid interest.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The carrying value of the Company&amp;#x2019;s long-term debt was
 $2.0&amp;#xA0;billion and $1.8&amp;#xA0;billion at December&amp;#xA0;31, 2018
 and 2017, respectively, and consisted of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="56%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31, 2018&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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Principal&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Unamortized&lt;br /&gt;
 Debt&lt;br /&gt;
 Issuance&lt;br /&gt;
 Costs&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Total&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Senior Notes&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;1,250,000&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(15,408&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,234,592&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Revolving line of credit&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;739,500&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;(4,274&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;735,226&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,989,500&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(19,682&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,969,818&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="56%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" 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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Principal&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Unamortized&lt;br /&gt;
 Debt&lt;br /&gt;
 Issuance&lt;br /&gt;
 Costs&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Total&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Senior Notes&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;750,000&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(9,503&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;740,497&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Revolving line of credit&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;1,110,500&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;(4,864&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;1,105,636&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,860,500&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(14,367&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;1,846,133&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company presents issuance costs related to long-term debt
 liabilities, other than revolving credit arrangements, as a direct
 deduction from the carrying value of that long-term debt. The
 Company has outstanding letters of credit which reduced the amount
 available under the Credit Agreement by $0.2&amp;#xA0;million at
 December&amp;#xA0;31, 2018. At December&amp;#xA0;31, 2018, the Company had
 an available balance on its Credit Agreement of
 $1.3&amp;#xA0;billion.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The carrying values of the Company&amp;#x2019;s variable rate revolving
 line of credit approximates fair value due to the short-term nature
 of the interest rates. The estimated fair value of the
 Company&amp;#x2019;s 2023 Notes and 2027 Notes were estimated using
 trading prices as of December&amp;#xA0;31, 2018 and 2017, respectively,
 as Level&amp;#xA0;2 inputs to estimate fair value and are summarized as
 follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="70%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2023 Notes&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;736,725&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;763,125&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2027 Notes&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;482,500&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;b&gt;&amp;#xA0;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &lt;b&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;b&gt;&amp;#xA0;&lt;/b&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company&amp;#x2019;s capital lease obligations consist of the
 following (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="76%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Capital lease obligations&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;441&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;1,826&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Less: Current portion&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;(253&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;(1,401&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Long-term portion&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;188&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;425&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The amounts due under the terms of the Company&amp;#x2019;s capital
 lease obligations at December&amp;#xA0;31, 2018 are as follows:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="89%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2019&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;253&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2020&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;114&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2021&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;74&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</us-gaap:DebtAndCapitalLeasesDisclosuresTextBlock>
  <us-gaap:ConsolidationPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_4779D21A-690D-4E4A-A739-ABD6C6E784C5_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt"&gt;
 &lt;b&gt;Principles of Presentation&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The consolidated financial statements include all the accounts of
 the Company and its subsidiaries combined with the accounts of the
 affiliated professional contractors with which the Company
 currently has specific management arrangements. The Company&amp;#x2019;s
 agreements with affiliated professional contractors provide that
 the term of the arrangements are in most cases permanent, subject
 only to termination by the Company, except in the case of gross
 negligence, fraud or bankruptcy of the Company. The Company has the
 right to receive income, both as ongoing fees and as proceeds from
 the sale of its interest in the Company&amp;#x2019;s affiliated
 professional contractors, in an amount that fluctuates based on the
 performance of the affiliated professional contractors and the
 change in the fair value of the Company&amp;#x2019;s interest in the
 affiliated professional contractors. The Company has exclusive
 responsibility for the provision of all &lt;font style="WHITE-SPACE: nowrap"&gt;non-medical&lt;/font&gt; services required for the
 &lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;day-to-day&lt;/font&gt;&lt;/font&gt; operation and
 management of the Company&amp;#x2019;s affiliated professional
 contractors and establishes the guidelines for the employment and
 compensation of the physicians. In addition, the agreements provide
 that the Company has the right, but not the obligation, to
 purchase, or to designate a person(s) to purchase, the stock of the
 Company&amp;#x2019;s affiliated professional contractors for a nominal
 amount. Separately, in its sole discretion, the Company has the
 right to assign its interest in the agreements. Based upon the
 provisions of these agreements, the Company has determined that the
 affiliated professional contractors are variable interest entities
 and that the Company is the primary beneficiary as defined in the
 accounting guidance for consolidation. All significant intercompany
 and interaffiliate accounts and transactions have been
 eliminated.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 The Company is a 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.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:ConsolidationPolicyTextBlock>
  <us-gaap:CurrentFederalTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_1_0">97754000</us-gaap:CurrentFederalTaxExpenseBenefit>
  <us-gaap:CurrentStateAndLocalTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_1_3">26605000</us-gaap:CurrentStateAndLocalTaxExpenseBenefit>
  <dei:CurrentFiscalYearEndDate contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_3">--12-31</dei:CurrentFiscalYearEndDate>
  <us-gaap:DeferredFederalIncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_1_1">-20176000</us-gaap:DeferredFederalIncomeTaxExpenseBenefit>
  <us-gaap:DeferredIncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_6">-24149000</us-gaap:DeferredIncomeTaxExpenseBenefit>
  <us-gaap:DeferredStateAndLocalIncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_1_4">-3973000</us-gaap:DeferredStateAndLocalIncomeTaxExpenseBenefit>
  <us-gaap:Depreciation contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5AB7E65F-6B18-4C0B-979C-191C7614027B_1_2">38500000</us-gaap:Depreciation>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_5">111281000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_9C348642-D21B-4E69-B14B-249F3DFF7335_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;13. &amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Stock Incentive Plans and Stock
 Purchase Plans:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Under the Amended and Restated 2008 Incentive Plan, options to
 purchase shares of common stock may be granted at a price not less
 than the fair market value of the shares on the date of grant. The
 options must be exercised within 10 years from the date of grant
 and generally become exercisable on a pro rata basis over a
 three-year period from the date of grant. The Company issues new
 shares of its common stock upon exercise of its stock options.
 Restricted stock awards generally vest over periods of three years
 upon the fulfillment of specified service-based conditions and in
 certain instances performance-based conditions. Deferred stock
 awards generally vest upon the satisfaction of specified
 performance-based conditions or service-based conditions. The
 Company recognizes compensation expense related to its restricted
 stock and deferred stock awards ratably over the corresponding
 vesting periods. At December&amp;#xA0;31, 2018, the Company had
 2.0&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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Under the Company&amp;#x2019;s 1996&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;Non-Qualified&lt;/font&gt;&amp;#xA0;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&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;Non-Qualified&lt;/font&gt;&amp;#xA0;Stock
 Purchase Plan (the &amp;#x201C;SPP&amp;#x201D;), certain
 eligible&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-employee&lt;/font&gt;&amp;#xA0;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="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Each of the ESPP and the SPP provide for the issuance of an of
 aggregate 2.6&amp;#xA0;million shares of the Company&amp;#x2019;s common
 stock less the number of shares of common stock purchased under the
 other plan. The Company recognizes stock-based compensation expense
 for the discount received by participating employees
 and&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-employee&lt;/font&gt;&amp;#xA0;service
 providers. During the year ended December&amp;#xA0;31, 2018,
 0.4&amp;#xA0;million shares were issued under the ESPP and SPP. At
 December&amp;#xA0;31, 2018, the Company had 1.6&amp;#xA0;million shares in
 aggregate reserved for issuance under the ESPP and SPP.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company recognized $38.7&amp;#xA0;million, $29.6&amp;#xA0;million and
 $34.0&amp;#xA0;million of stock-based compensation expense related to
 its stock incentive plans, the ESPP and the SPP during the years
 ended December&amp;#xA0;31, 2018, 2017 and 2016, respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The activity related to the Company&amp;#x2019;s restricted stock and
 deferred stock awards and the corresponding weighted average
 grant-date fair values for the year ended December&amp;#xA0;31, 2018
 are as follows:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="68%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Number of&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Shares&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Weighted&lt;br /&gt;
 Average&amp;#xA0;Fair&lt;br /&gt;
 Value&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Non-vested&lt;/font&gt;&amp;#xA0;shares at
 January&amp;#xA0;1, 2018&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;1,041,034&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;60.21&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Awarded&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;770,480&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;51.99&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Forfeited&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(69,293&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;56.65&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Vested&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;(431,368&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;63.57&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Non-vested&lt;/font&gt;&amp;#xA0;shares at
 December&amp;#xA0;31, 2018&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,310,853&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;54.46&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The aggregate fair value of the restricted and deferred stock that
 vested during the years ended December&amp;#xA0;31, 2018, 2017 and 2016
 was $27.4&amp;#xA0;million, $29.3&amp;#xA0;million and $29.8&amp;#xA0;million,
 respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The weighted average grant-date fair value of restricted and
 deferred stock awards that were granted during the years ended
 December&amp;#xA0;31, 2018, 2017 and 2016 was $51.99, $54.22 and
 $67.90, respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 At December&amp;#xA0;31, 2018, the total stock-based compensation cost
 related to&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-vested&lt;/font&gt;&amp;#xA0;restricted
 and deferred stock remaining to be recognized as compensation
 expense over a weighted-average period of 1.4 years was
 $30.8&amp;#xA0;million.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company did not grant any stock options in 2018, 2017, or 2016,
 and all stock-based compensation cost related to stock options has
 been recognized. The activity and certain other information related
 to the Company&amp;#x2019;s outstanding stock option awards for the year
 ended December&amp;#xA0;31, 2018 are as follows:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="51%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Number&amp;#xA0;of&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Stock&amp;#xA0;Options&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Weighted&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Average&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Exercise&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Price&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Weighted&lt;br /&gt;
 Average&lt;br /&gt;
 Remaining&lt;br /&gt;
 Contractual&lt;br /&gt;
 Term&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;(in years)&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Aggregate&lt;br /&gt;
 Intrinsic&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Value&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;(in&lt;br /&gt;
 millions)&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Outstanding at January&amp;#xA0;1, 2018&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;246,342&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;27.51&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"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Exercised&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;(133,366&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27.38&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2.8&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: rgb(0,0,0) 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: rgb(0,0,0) 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;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Outstanding and exercisable at December&amp;#xA0;31, 2018&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;112,976&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27.65&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.3&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.7&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: rgb(0,0,0) 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: rgb(0,0,0) 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;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The aggregate intrinsic value of stock options exercised during the
 years ended December&amp;#xA0;31, 2018, 2017 and 2016 was
 $2.8&amp;#xA0;million, $5.5&amp;#xA0;million and $6.8&amp;#xA0;million,
 respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 There were no excess tax benefits recognized in
 additional&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;paid-in&lt;/font&gt;&amp;#xA0;capital in
 2018 or 2017 due to the adoption of new accounting guidance on
 January&amp;#xA0;1, 2017 that requires excess tax benefits to be
 recognized in the income statement. The net excess tax benefit
 recognized in additional&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;paid-in&lt;/font&gt;&amp;#xA0;capital
 related primarily to stock options, restricted stock and deferred
 stock for the year ended December&amp;#xA0;31, 2016 was
 $4.1&amp;#xA0;million. The cash proceeds received from the exercise of
 stock options for the years ended December&amp;#xA0;31, 2018, 2017 and
 2016 were $3.7&amp;#xA0;million, $4.8&amp;#xA0;million and
 $4.7&amp;#xA0;million, respectively.&lt;/p&gt;


 &lt;/div&gt;</us-gaap:DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock>
  <dei:DocumentFiscalPeriodFocus contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_34DAAF8E-0206-4455-816A-0C734573D691_1_4">FY</dei:DocumentFiscalPeriodFocus>
  <dei:DocumentFiscalYearFocus contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_34DAAF8E-0206-4455-816A-0C734573D691_1_3">2018</dei:DocumentFiscalYearFocus>
  <dei:DocumentType contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_34DAAF8E-0206-4455-816A-0C734573D691_1_0">10-K</dei:DocumentType>
  <us-gaap:DefinedContributionPlanCostRecognized contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_99CF5A6E-BE3D-4251-BDB1-4F0036EE4DA6_1_0">55800000</us-gaap:DefinedContributionPlanCostRecognized>
  <us-gaap:DisaggregationOfRevenueTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_A7607FCB-02A3-422D-9906-2AF37579C86A_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Net revenue consists of the following (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="55%"&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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3,067,784&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,915,648&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;2,760,192&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;363,369&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;315,778&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;271,886&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;215,970&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;226,886&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;151,081&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;&amp;#xA0;3,647,123&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;3,458,312&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;3,183,159&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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-K0015_STD_365_20181231_0" id="id_14062202_156FA49D-5310-41E1-A288-7BF5921BF860_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;12. &amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Common and Common Equivalent
 Shares:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The calculation of shares used in the basic and diluted net income
 per share calculation for the years ended December&amp;#xA0;31, 2018,
 2017 and 2016 is as follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="73%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;91,104&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;92,431&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;92,422&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;502&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;527&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;687&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;91,606&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;92,958&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;93,109&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;214&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;107&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&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:EarningsPerShareTextBlock>
  <us-gaap:EffectiveIncomeTaxRateContinuingOperations contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="pure" decimals="4" id="id_14062202_825CA47E-8C6C-4752-B30C-4D0591235E93_1_1">0.2717</us-gaap:EffectiveIncomeTaxRateContinuingOperations>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_19">2.93</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EarningsPerSharePolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_B4179526-672E-4578-87A3-74D4915F00D3_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Net Income Per Common Share&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Basic net income per common share is calculated by dividing net
 income by the weighted average number of common shares outstanding
 during the period. Diluted net income per common share is
 calculated by dividing net income by the weighted average number of
 common and potential common shares outstanding during the period.
 Potential common shares consist of outstanding restricted stock,
 deferred stock and stock options and is calculated using the
 treasury stock method. On January&amp;#xA0;1, 2017, the Company adopted
 new accounting guidance that no longer permits the Company to
 include the assumed excess tax benefits related to the potential
 exercise or vesting of its stock-based awards in the treasury stock
 method computation.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:EarningsPerSharePolicyTextBlock>
  <us-gaap:EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="pure" decimals="INF" id="id_14062202_825CA47E-8C6C-4752-B30C-4D0591235E93_1_0">0.210</us-gaap:EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate>
  <us-gaap:EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_1_5">0.0120</us-gaap:EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent>
  <dei:EntityCentralIndexKey contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_2">0000893949</dei:EntityCentralIndexKey>
  <dei:EntityWellKnownSeasonedIssuer contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_4">Yes</dei:EntityWellKnownSeasonedIssuer>
  <us-gaap:EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_1_1">0.0480</us-gaap:EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes>
  <dei:EntityRegistrantName contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_1">MEDNAX, INC.</dei:EntityRegistrantName>
  <dei:EntityShellCompany contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_10">false</dei:EntityShellCompany>
  <dei:EntitySmallBusiness contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_11">false</dei:EntitySmallBusiness>
  <dei:EntityVoluntaryFilers contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_6">No</dei:EntityVoluntaryFilers>
  <dei:DocumentPeriodEndDate contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_34DAAF8E-0206-4455-816A-0C734573D691_1_2">2018-12-31</dei:DocumentPeriodEndDate>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_18">2.95</us-gaap:EarningsPerShareBasic>
  <us-gaap:EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_1_6">-0.0032</us-gaap:EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate>
  <us-gaap:EffectiveIncomeTaxRateReconciliationNondeductibleExpense contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_1_2">0.0044</us-gaap:EffectiveIncomeTaxRateReconciliationNondeductibleExpense>
  <us-gaap:EffectiveIncomeTaxRateReconciliationOtherAdjustments contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_1_3">0.0005</us-gaap:EffectiveIncomeTaxRateReconciliationOtherAdjustments>
  <dei:EntityCurrentReportingStatus contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_5">Yes</dei:EntityCurrentReportingStatus>
  <dei:EntityEmergingGrowthCompany contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_8">false</dei:EntityEmergingGrowthCompany>
  <dei:EntityExTransitionPeriod contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_9">false</dei:EntityExTransitionPeriod>
  <dei:EntityFilerCategory contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_7">Large Accelerated Filer</dei:EntityFilerCategory>
  <us-gaap:FairValueOfFinancialInstrumentsPolicy contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_FA4C33C7-8AEF-4318-9E66-DADE9838CDC6_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Fair Value Measurements&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 In accordance with the accounting guidance for fair value
 measurements and disclosures, the Company carries its money market
 funds included in cash and cash equivalents at fair value. In
 accordance with the three-tier fair value hierarchy under this
 guidance, the Company determined the fair value using quoted market
 prices, a Level&amp;#xA0;1 input as defined under the accounting
 guidance for fair value measurements. At December&amp;#xA0;31, 2018 and
 2017, the Company&amp;#x2019;s money market funds had a fair value of
 $0.5&amp;#xA0;million and $9.2&amp;#xA0;million, respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company also carries the cash surrender value of life insurance
 related to its deferred compensation arrangements at fair value.
 The investments underlying the life insurance contracts consist
 primarily of exchange-traded equity securities and mutual funds
 with quoted prices in active markets. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value using the cash surrender value of the life insurance, a
 Level&amp;#xA0;2 input as defined under the accounting guidance for
 fair value measurements. At December&amp;#xA0;31, 2018 and 2017, the
 Company&amp;#x2019;s cash surrender value of life insurance had a fair
 value of $10.5&amp;#xA0;million and $15.6&amp;#xA0;million,
 respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 In addition, the Company carries its contingent consideration
 liabilities related to acquisitions at fair value. In accordance
 with the three-tier fair value hierarchy, the Company determined
 the fair value of its contingent consideration liabilities using
 the income approach with assumed discount rates and payment
 probabilities. The income approach uses Level&amp;#xA0;3, or
 unobservable inputs as defined under the accounting guidance for
 fair value measurements. At December&amp;#xA0;31, 2018 and 2017, the
 Company&amp;#x2019;s contingent consideration liabilities had a fair
 value of $20.0&amp;#xA0;million and $30.5&amp;#xA0;million, respectively.
 See Note 6 for more information regarding the Company&amp;#x2019;s
 contingent consideration liabilities.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The carrying amounts of cash equivalents, short-term investments,
 accounts receivable and accounts payable and accrued expenses
 approximate fair value due to the short maturities of the
 respective instruments. The carrying values of long-term
 investments, line of credit, variable rate long-term debt and
 capital lease obligations approximate fair value. If the
 Company&amp;#x2019;s investments were measured at fair value, they would
 be categorized as Level&amp;#xA0;2 in the fair value hierarchy. If the
 Company&amp;#x2019;s line of credit was measured at fair value, it would
 be categorized as Level&amp;#xA0;2 in the fair value hierarchy. See
 Note 10 for information regarding the fair value of the
 Company&amp;#x2019;s 5.25% senior unsecured notes due 2023 (the
 &amp;#x201C;2023 Notes&amp;#x201D;) and 6.25% senior unsecured notes due 2027
 (the &amp;#x201C;2027 Notes&amp;#x201D;).&lt;/p&gt;


 &lt;/div&gt;</us-gaap:FairValueOfFinancialInstrumentsPolicy>
  <us-gaap:FederalIncomeTaxExpenseBenefitContinuingOperations contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_1_2">77578000</us-gaap:FederalIncomeTaxExpenseBenefitContinuingOperations>
  <us-gaap:GoodwillAndIntangibleAssetsDisclosureTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_6A0AEB4F-5232-4966-BB8F-2A1F74A9C20F_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;7.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Goodwill and Intangible
 Assets:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Goodwill was $4.4&amp;#xA0;billion and $4.3&amp;#xA0;billion at
 December&amp;#xA0;31, 2018 and 2017, respectively. The change in the
 carrying amount of goodwill of $99.0&amp;#xA0;million during the year
 ended December&amp;#xA0;31, 2018 is primarily related to the
 Company&amp;#x2019;s 2018 acquisitions. The Company expects that
 $63.0&amp;#xA0;million of the goodwill recorded during the year ended
 December&amp;#xA0;31, 2018 will be deductible for tax purposes.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&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 December&amp;#xA0;31, 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;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Intangible assets, net, consist of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="63%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31, 2018&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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Gross&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Accumulated&lt;br /&gt;
 Amortization&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Net&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Physician and hospital agreements&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;&amp;#xA0;376,871&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;(223,589)&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;153,282&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Customer relationships&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;443,300&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;(71,870&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;371,430&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Trade names&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;43,156&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;(4,630&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;38,526&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Patented and other technology&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;47,561&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(22,487&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;25,074&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;910,888&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(322,576)&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;588,312&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="63%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" 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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Gross&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Accumulated&lt;br /&gt;
 Amortization&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Net&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Physician and hospital agreements&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;&amp;#xA0;381,635&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;(203,915)&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;177,720&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Customer relationships&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;443,300&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;(48,837&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;394,463&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Trade names&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;43,156&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;(2,933&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;40,223&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Patented and other technology&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;38,590&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;(11,068&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;27,522&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;906,681&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(266,753)&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;639,928&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 During the year ended December&amp;#xA0;31, 2018, the Company recorded
 intangible assets related to acquisitions totaling
 $17.2&amp;#xA0;million, consisting primarily of physician and hospital
 agreements. The weighted-average amortization period for these
 physician and hospital agreements is approximately nine years.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Amortization expense for intangible assets was $72.8&amp;#xA0;million,
 $68.9&amp;#xA0;million and $60.3&amp;#xA0;million for the years ended
 December&amp;#xA0;31, 2018, 2017 and 2016, respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Amortization expense for existing intangible assets for the next
 five years is expected to be as follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="84%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2019&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;66,532&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2020&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;59,969&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2021&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;53,771&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2022&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;46,249&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2023&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;40,448&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</us-gaap:GoodwillAndIntangibleAssetsDisclosureTextBlock>
  <us-gaap:GoodwillPeriodIncreaseDecrease contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_4623442B-D13E-4123-AD46-F9D0706315D4_1_400001">99000000</us-gaap:GoodwillPeriodIncreaseDecrease>
  <us-gaap:GoodwillAndIntangibleAssetsPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_10451BEB-2437-4FCE-B585-8818CFA4AFEB_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Goodwill and Other Intangible Assets&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The Company records acquired assets and assumed liabilities at
 their respective fair values under the acquisition method of
 accounting. Goodwill represents the excess of purchase price over
 the fair value of the net assets acquired. Intangible assets with
 finite lives, principally physician and hospital agreements,
 customer relationships, patented technology and trade names, are
 recognized apart from goodwill at the time of acquisition based on
 the contractual-legal and separability criteria established in the
 accounting guidance. Intangible assets with finite lives are
 amortized on either an accelerated basis based on the annual
 undiscounted economic cash flows associated with the particular
 intangible asset or on a straight-line basis over their estimated
 useful lives. Intangible assets with finite lives are amortized
 over periods of one to 20 years.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 Goodwill is tested for impairment at a reporting unit level on at
 least an annual basis in accordance with the subsequent measurement
 provisions of the accounting guidance for goodwill. The Company
 defines a reporting unit based upon its management structure for
 services provided in specific regions of the United States. The
 Company early adopted new accounting guidance in 2017 that requires
 only a single-step quantitative test with any goodwill impairment
 measured as the amount by which a reporting unit&amp;#x2019;s carrying
 value exceeds its fair value. The Company uses income and
 market-based valuation approaches to determine the fair value of
 its reporting units. These approaches focus on discounted cash
 flows and market multiples based on the Company&amp;#x2019;s market
 capitalization to derive the fair value of a reporting unit. The
 Company also considers the economic outlook for the healthcare
 services industry and various other factors during the testing
 process, including hospital and physician contract changes, local
 market developments, changes in third-party payor payments, and
 other publicly available information. The Company completed annual
 impairment tests in the third quarter of each of 2018, 2017 and
 2016 and determined that goodwill was not impaired in any of the
 three years.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:GoodwillAndIntangibleAssetsPolicyTextBlock>
  <us-gaap:FinitelivedIntangibleAssetsAcquired1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_E248977C-23F7-45C4-8AD2-68E3BCBBB7B9_1_0">17200000</us-gaap:FinitelivedIntangibleAssetsAcquired1>
  <us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_9C6F4F46-CD2D-4590-9AB9-595720856CA6_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Amortization expense for existing intangible assets for the next
 five years is expected to be as follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="84%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2019&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;66,532&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2020&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;59,969&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2021&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;53,771&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2022&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;46,249&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2023&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;40,448&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</us-gaap:FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_4">432378000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_12">368839000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_10">6825000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_13">100210000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:IncreaseDecreaseInDeferredLiabilities contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_13115251-1E4D-4A11-8B86-C3744219AE4D_1_0">-23600000</us-gaap:IncreaseDecreaseInDeferredLiabilities>
  <us-gaap:IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_15">-4490000</us-gaap:IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve>
  <us-gaap:IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_10">5472000</us-gaap:IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets>
  <us-gaap:IncomeTaxDisclosureTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_A082A9AF-5FE2-44E4-9D97-49744B51C4C4_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;11.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Income Taxes:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The components of the income tax provision (benefit) are as follows
 (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="63%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Federal:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;97,754&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;130,053&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;166,758&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(20,176&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;(63,038&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;15,596&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;77,578&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;67,015&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;182,354&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 State:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,605&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;20,070&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;4,296&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(3,973&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;2,965&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,553&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;22,632&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;23,035&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6,849&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;100,210&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;90,050&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;189,203&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company files its tax return on a consolidated basis with its
 subsidiaries, and its affiliated professional contractors file tax
 returns on an individual basis.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Beginning on January&amp;#xA0;1, 2018, the Company&amp;#x2019;s statutory
 tax rate was reduced from 35.0% to 21.0% as a result of legislation
 enacted under the Tax Cuts and Jobs Act of 2017
 (&amp;#x201C;TCJA&amp;#x201D;). The effective tax rate was 27.2%, 21.9% and
 36.8% for the years ended December&amp;#xA0;31, 2018, 2017 and 2016,
 respectively. During the three months ended December&amp;#xA0;31, 2017,
 the Company recorded a $70.0&amp;#xA0;million income tax benefit
 related to the reduction of its net deferred tax liability
 resulting from the reduction in the corporate tax rate under the
 TCJA. During the three months ended September&amp;#xA0;30, 2016, the
 Company settled a certain tax matter with a taxing authority. In
 connection with this settlement, the Company&amp;#x2019;s effective
 income tax rate was favorably impacted by $10.6&amp;#xA0;million.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The differences between the effective rate and the United States
 federal income tax statutory rate are as follows:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Tax at statutory rate&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;21.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;35.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;35.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 State income tax, net of federal benefit&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;4.80&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3.33&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2.94&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Non-deductible&lt;/font&gt;&amp;#xA0;expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.44&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.49&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.43&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in accrual estimates relating to uncertain tax positions&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.05&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.02&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(2.11&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in valuation allowance&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.48&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Other, net&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.20&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.16&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.06&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in tax law&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(0.32&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17.06&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax provision&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27.17&lt;/td&gt;
 &lt;td valign="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;21.94&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;36.80&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 All of the Company&amp;#x2019;s deferred tax assets and liabilities are
 classified as long-term. The significant components of deferred
 income tax assets and liabilities are as follows (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="69%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Allowance for uncollectible accounts&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;194,876&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;80,056&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Reserves and accruals&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;59,270&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;45,454&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Stock-based compensation&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;9,201&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;7,975&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net operating loss carryforward&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;25,226&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;28,569&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Property and equipment&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&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;685&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 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;1,197&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;970&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred tax assets before valuation allowance&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;289,796&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;163,709&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Less: Valuation allowance&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(2,628&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;(2,615&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred tax assets, net of valuation allowance&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;287,168&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;161,094&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Gross deferred tax liabilities:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Amortization&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(286,552&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;(258,618&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Accounting method changes&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;(109,418&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;(4,150&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Accrual to cash adjustment&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;(39&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;(31,290&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 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;(489&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total deferred tax 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;(396,498&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;(294,058&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net deferred tax liability&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;(109,330&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;(132,964&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company&amp;#x2019;s net deferred tax liability decreased by
 $23.6&amp;#xA0;million during 2018. During 2018, certain of the
 Company&amp;#x2019;s affiliated professional contractors elected to
 change their method of accounting from cash basis to accrual basis
 for income tax purposes. During the year ended December&amp;#xA0;31,
 2018, the increases in allowance for uncollectible accounts of
 $114.8&amp;#xA0;million and accounting method changes of
 $105.3&amp;#xA0;million as well as the decrease in accrual to cash
 adjustment of $31.3&amp;#xA0;million primarily relate to these
 accounting method changes.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Beginning January&amp;#xA0;1, 2017, excess tax benefits or deficiencies
 associated with the exercise of stock options, the vesting of
 restricted and deferred stock and the purchase of shares under the
 Company&amp;#x2019;s&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-qualified&lt;/font&gt;&amp;#xA0;employee
 stock purchase plan are recognized as income tax benefits or
 expenses in the income statement in the reporting period in which
 they occur instead of an increase or decrease to
 additional&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;paid-in-capital.&lt;/font&gt;&lt;/font&gt;&amp;#xA0;For
 the years ended December&amp;#xA0;31, 2018 and 2017, income tax expense
 of $1.4&amp;#xA0;million and $0.2&amp;#xA0;million, respectively, was
 recognized for excess tax deficiencies. For the year ended
 December&amp;#xA0;31, 2016, additional&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;paid-in-capital&lt;/font&gt;&lt;/font&gt;&amp;#xA0;was
 increased by $4.2&amp;#xA0;million for excess tax benefits.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company has net operating loss carryforwards for federal and
 state tax purposes totaling $101.9&amp;#xA0;million,
 $116.0&amp;#xA0;million and $130.0&amp;#xA0;million at December&amp;#xA0;31,
 2018, 2017 and 2016, respectively. With respect to the
 December&amp;#xA0;31, 2018 balance, approximately $74.3&amp;#xA0;million
 expires at various times from 2019 through 2038, and
 $27.6&amp;#xA0;million does not expire.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 As of December&amp;#xA0;31, 2018, 2017 and 2016, the Company&amp;#x2019;s
 liability for uncertain tax positions, excluding accrued interest
 and penalties, was $11.2&amp;#xA0;million, $11.0&amp;#xA0;million and
 $9.5&amp;#xA0;million, respectively. As of December&amp;#xA0;31, 2018, the
 Company had $10.9&amp;#xA0;million of uncertain tax positions that, if
 recognized, would favorably impact its effective tax rate.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The following table summarizes the activity related to the
 Company&amp;#x2019;s liability for uncertain tax positions for the years
 ended December&amp;#xA0;31, 2018, 2017 and 2016 (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="66%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Balance at beginning of year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,972&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;9,469&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;18,447&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Increases related to prior year tax positions&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;385&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;2,284&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;301&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Decreases related to prior year tax positions&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;(143&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(3,927&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Increases related to current year tax positions&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,900&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;1,430&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;2,258&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Settlements&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" 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;(5,644&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Decreases related to lapse of statutes of limitation&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(3,072&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;(2,068&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;(1,966&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Balance at end of year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;11,185&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,972&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;9,469&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 During the years ended December&amp;#xA0;31, 2018 and 2017, the Company
 increased its liability for uncertain tax positions by a total of
 $0.2&amp;#xA0;million and $1.5&amp;#xA0;million, respectively, primarily
 related to additional taxes on current and prior year positions,
 partially offset by the expiration of statutes of limitation. In
 addition, the Company anticipates that its liability for uncertain
 tax positions will increase by $0.2&amp;#xA0;million over the next 12
 months.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company includes interest and penalties related to income tax
 liabilities in income tax expense. The income tax benefit
 recognized by the Company for interest and penalties during the
 year ended December&amp;#xA0;31, 2018 was nominal. The Company
 recognized income tax benefits of $0.2&amp;#xA0;million and
 $7.9&amp;#xA0;million related to interest and penalties during the
 years ended December&amp;#xA0;31, 2017 and 2016, respectively. At
 December&amp;#xA0;31, 2018 and 2017, the Company&amp;#x2019;s accrued
 liability for interest and penalties related to income tax
 liabilities totaled $1.1&amp;#xA0;million and $1.2&amp;#xA0;million,
 respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company is currently subject to U.S. Federal and various state
 income tax examinations for the tax years 2014 through 2017.&lt;/p&gt;


 &lt;/div&gt;</us-gaap:IncomeTaxDisclosureTextBlock>
  <us-gaap:IncomeTaxesPaidNet contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_44">185416000</us-gaap:IncomeTaxesPaidNet>
  <us-gaap:HeldToMaturitySecuritiesTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_DF44C7C4-5742-4822-8D16-F04ED43D288E_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Investments held are summarized as follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="52%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31, 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;18,473&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,841&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Federal home loan securities&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,000&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;34,393&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;1,450&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;4,465&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;21,923&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;69,699&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_993CD355-2767-4D6F-B2D4-A6C71D5BB3AC_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Long-Lived Assets&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The Company is required to evaluate long-lived assets, including
 intangible assets subject to amortization, whenever events or
 changes in circumstances indicate that the carrying value of the
 assets may not be fully recoverable. The recoverability of such
 assets is measured by a comparison of the carrying value of the
 assets to the future undiscounted cash flows before interest
 charges to be generated by the assets. If long-lived assets are
 impaired, the impairment to be recognized is measured as the excess
 of the carrying value over the fair value. Long-lived assets held
 for disposal are reported at the lower of the carrying value or
 fair value less disposal costs. The Company does not believe there
 are any indicators that would require an adjustment to such assets
 or their estimated periods of recovery at December&amp;#xA0;31, 2018
 pursuant to current accounting standards.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock>
  <us-gaap:IncomeTaxPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_D62B6F8F-A9DF-43F0-A49C-05DBC05D828E_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Income Taxes&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The Company records deferred income taxes using the liability
 method, whereby deferred tax assets and liabilities are determined
 based on the difference between the financial statement and tax
 bases of assets and liabilities using enacted tax rates in effect
 for the year in which the differences are expected to reverse. If
 it is more likely than not that all or a portion of deferred tax
 assets will not be realized, a valuation allowance is provided
 against such deferred tax assets. In making such determination, the
 Company considers all available positive and negative evidence,
 including future reversals of existing taxable temporary
 differences, projected future taxable income, &lt;font style="WHITE-SPACE: nowrap"&gt;tax-planning&lt;/font&gt; strategies, and results
 of recent operations.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 The accounting guidance for uncertain tax positions prescribes a
 recognition threshold and measurement attribute for financial
 statement recognition and measurement of a tax position taken or
 expected to be taken in a tax return. The guidance also requires
 policy disclosures regarding penalties and interest and extensive
 disclosures regarding increases and decreases in uncertain tax
 positions as a result of tax positions taken in a current or prior
 period, settlements with taxing authorities and any lapse of an
 applicable statute of limitations. Additional qualitative
 discussion is required for any tax position that may result in a
 significant increase or decrease in uncertain tax positions within
 a &lt;font style="WHITE-SPACE: nowrap"&gt;12-month&lt;/font&gt; period from the
 Company&amp;#x2019;s reporting date.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:IncomeTaxPolicyTextBlock>
  <us-gaap:IncreaseDecreaseInAccountsPayableAndAccruedLiabilities contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_12">15390000</us-gaap:IncreaseDecreaseInAccountsPayableAndAccruedLiabilities>
  <us-gaap:IncreaseDecreaseInAccruedIncomeTaxesPayable contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_13">-61256000</us-gaap:IncreaseDecreaseInAccruedIncomeTaxesPayable>
  <us-gaap:IncreaseDecreaseInOtherNoncurrentAssets contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_11">395000</us-gaap:IncreaseDecreaseInOtherNoncurrentAssets>
  <us-gaap:IncreaseDecreaseInAccountsReceivable contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_9">36598000</us-gaap:IncreaseDecreaseInAccountsReceivable>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_9">88769000</us-gaap:InterestExpense>
  <us-gaap:InvestmentPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_2F5BD16A-99C6-438F-A419-9DD2FDCE5E84_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Investments&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Investments 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 five years.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 The Company intends and has the ability to hold its securities to
 maturity, and therefore carries such investments at amortized cost
 in accordance with the provisions of the accounting guidance for
 investments in debt securities.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:InvestmentPolicyTextBlock>
  <us-gaap:IncreaseDecreaseInOtherOperatingLiabilities contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_16">-4294000</us-gaap:IncreaseDecreaseInOtherOperatingLiabilities>
  <us-gaap:IncrementalCommonSharesAttributableToShareBasedPaymentArrangements contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="shares" decimals="-3" id="id_14062202_5D948726-9D47-457B-BD6D-63332D0C9B24_1_1">502000</us-gaap:IncrementalCommonSharesAttributableToShareBasedPaymentArrangements>
  <us-gaap:InterestPaidNet contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_43">82540000</us-gaap:InterestPaidNet>
  <us-gaap:InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0648AD5A-DF6B-49D5-B8C1-681974DDB50F_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;3. &amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Investments:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Investments held are summarized as follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="52%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31, 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;18,473&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,841&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Federal home loan securities&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,000&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;34,393&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;1,450&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;4,465&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;21,923&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;69,699&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&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; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="74%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;69,699&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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" 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;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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;69,699&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_8">4935000</us-gaap:InvestmentIncomeNet>
  <us-gaap:InvestmentsClassifiedByContractualMaturityDateTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_1F93EC27-1806-4326-AADE-DC473C423485_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&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; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="74%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;69,699&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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" 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;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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;69,699&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:LeaseAndRentalExpense contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_EE3DBF28-717E-4E17-B56B-93BBC8045234_1_0">42900000</us-gaap:LeaseAndRentalExpense>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredNet contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_1_7">52254000</us-gaap:MalpracticeLossContingencyClaimsIncurredNet>
  <us-gaap:LineOfCreditFacilityExpirationDate1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_66FDBE91-E4FE-4785-BA00-47E5693D636F_1_2">2022-10-31</us-gaap:LineOfCreditFacilityExpirationDate1>
  <us-gaap:NatureOfOperations contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_CEC2BF27-90C9-4CEF-800B-EB0CEC8A248C_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;1.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;General:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The principal business activity of MEDNAX, Inc.
 (&amp;#x201C;MEDNAX&amp;#x201D; or the &amp;#x201C;Company&amp;#x201D;) and its
 subsidiaries is to provide neonatal, anesthesia, radiology and
 teleradiology, maternal-fetal and other pediatric subspecialty
 physician services. The Company has contracts with affiliated
 business corporations or professional associations, limited
 liability companies and partnerships (&amp;#x201C;affiliated
 professional contractors&amp;#x201D;), which are separate legal entities
 that provide physician services in certain states and Puerto Rico.
 The Company and its affiliated professional contractors also have
 contracts with hospitals and other healthcare facilities to provide
 physician services, which include&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;(i)&amp;#xA0;fee-for-service&lt;/font&gt;&lt;/font&gt;&amp;#xA0;contracts,
 whereby hospitals and other customers agree, in exchange for the
 Company&amp;#x2019;s services, to authorize the Company and its
 healthcare professionals to bill and collect the charges for
 medical services rendered by the Company&amp;#x2019;s affiliated
 healthcare professionals, and (ii)&amp;#xA0;administrative fee
 contracts, whereby the Company is assured a minimum revenue
 level.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 In addition to its national physician network, the Company also
 provides services nationwide to healthcare providers, including its
 own, through complementary businesses including a management
 services organization specializing in full-service revenue cycle
 management and a consulting services company.&lt;/p&gt;


 &lt;/div&gt;</us-gaap:NatureOfOperations>
  <us-gaap:NewAccountingPronouncementsPolicyPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_FD8ED104-4418-4EF5-8DB2-24921D76A23A_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;New Accounting Pronouncements&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&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 became 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 has
 accumulated all of the necessary information required to properly
 account for leases under the new guidance. The Company has
 implemented a cloud-based software application, inclusive of a
 lease administration module and an accounting module. The Company
 is in the process of finalizing workflows, business processes and
 internal controls surrounding the new lease accounting process in
 order to meet the reporting and disclosure requirements.&lt;/p&gt;


 &lt;/div&gt;</us-gaap:NewAccountingPronouncementsPolicyPolicyTextBlock>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_11">-77009000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredInPeriod contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_1_5">555000</us-gaap:MalpracticeLossContingencyClaimsIncurredInPeriod>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredInPriorPeriods contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_1_6">51699000</us-gaap:MalpracticeLossContingencyClaimsIncurredInPriorPeriods>
  <us-gaap:NetCashProvidedByUsedInInvestingActivities contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_25">-142769000</us-gaap:NetCashProvidedByUsedInInvestingActivities>
  <us-gaap:MalpracticeLossContingencyDisclosureTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_CCC038A7-0D00-4A19-84DD-A4BC286D37EE_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;9.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Accrued Professional
 Liabilities:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 At December&amp;#xA0;31, 2018 and 2017, the Company&amp;#x2019;s total
 accrued professional liabilities of $244.0&amp;#xA0;million and
 $250.2&amp;#xA0;million, respectively, included incurred but not
 reported loss reserves of $139.1&amp;#xA0;million and
 $138.5&amp;#xA0;million, respectively, and loss reserves for reported
 claims of $104.9&amp;#xA0;million and $111.7&amp;#xA0;million,
 respectively. Of the total liability, $34.9&amp;#xA0;million is
 classified as a current liability within accounts payable and
 accrued expenses in the Consolidated Balance Sheet. In addition,
 there is a corresponding insurance receivable of $16.7&amp;#xA0;million
 recorded as a component of other assets for certain professional
 liability claims that are covered by third-party insurance
 policies.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The activity related to the Company&amp;#x2019;s total accrued
 professional liability for the years ended December&amp;#xA0;31, 2018,
 2017 and 2016 is as follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="63%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Balance at beginning of year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;250,187&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;202,052&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;202,527&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Assumed liabilities through acquisition&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;1,276&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;20,716&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Provision (adjustment) for losses related to:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;34,483&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;41,291&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;38,129&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Prior 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;10,299&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;9,983&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;(25,428&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total provision for losses&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;44,782&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;51,274&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;12,701&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Claim payments related to:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current year&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;(555&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;(712&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;(766&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Prior 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;(51,699&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;(23,143&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(12,410&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total payments&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;(52,254&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;(23,855&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;(13,176&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Balance at end of year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;243,991&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;250,187&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;202,052&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The net decrease in the Company&amp;#x2019;s total accrued professional
 liability for the year ended December&amp;#xA0;31, 2018 was primarily
 related to an increase in claims payments made in the current year,
 partially offset by overall unfavorable trends in the
 Company&amp;#x2019;s claims experience that impacted its provision for
 losses. The net increase in the Company&amp;#x2019;s total accrued
 professional liability for the year ended December&amp;#xA0;31, 2017
 was primarily related to overall unfavorable trends in the
 Company&amp;#x2019;s claims experience that impacted its provision for
 losses and growth in the program from acquisitions.&lt;/p&gt;


 &lt;/div&gt;</us-gaap:MalpracticeLossContingencyDisclosureTextBlock>
  <us-gaap:NetCashProvidedByUsedInFinancingActivities contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_37">-170611000</us-gaap:NetCashProvidedByUsedInFinancingActivities>
  <us-gaap:NetCashProvidedByUsedInOperatingActivities contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_17">289925000</us-gaap:NetCashProvidedByUsedInOperatingActivities>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_16">268629000</us-gaap:NetIncomeLoss>
  <us-gaap:OtherNoncashIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_7">10903000</us-gaap:OtherNoncashIncomeExpense>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_6">3201275000</us-gaap:OperatingExpenses>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_7">445848000</us-gaap:OperatingIncomeLoss>
  <us-gaap:PaymentsForPreviousAcquisition contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_4E821083-0981-419D-A879-1B645A1175E9_1_0">6400000</us-gaap:PaymentsForPreviousAcquisition>
  <us-gaap:PaymentsOfFinancingCosts contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_30">7090000</us-gaap:PaymentsOfFinancingCosts>
  <us-gaap:PaymentsToAcquireInvestments contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_20">15884000</us-gaap:PaymentsToAcquireInvestments>
  <us-gaap:PaymentsToAcquireOtherPropertyPlantAndEquipment contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_22">48868000</us-gaap:PaymentsToAcquireOtherPropertyPlantAndEquipment>
  <us-gaap:PaymentsForRepurchaseOfCommonStock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_36">302160000</us-gaap:PaymentsForRepurchaseOfCommonStock>
  <us-gaap:PaymentsToAcquireBusinessesNetOfCashAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_19">114491000</us-gaap:PaymentsToAcquireBusinessesNetOfCashAcquired>
  <us-gaap:PaymentForContingentConsiderationLiabilityFinancingActivities contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_31">5263000</us-gaap:PaymentForContingentConsiderationLiabilityFinancingActivities>
  <us-gaap:PaymentForContingentConsiderationLiabilityOperatingActivities contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_14">1093000</us-gaap:PaymentForContingentConsiderationLiabilityOperatingActivities>
  <us-gaap:PensionAndOtherPostretirementBenefitsDisclosureTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_350A14EB-F1AA-4E88-83A1-A0F261EF4951_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;15. &amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Retirement Plans:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company maintains six qualified contributory savings plans as
 allowed under Section&amp;#xA0;401(k) of the Internal Revenue Code and
 Section&amp;#xA0;1165(e) of the Puerto Rico Income Tax Act of 1954 (the
 &amp;#x201C;401(k) Plans&amp;#x201D;). The 401(k) Plans permit participant
 contributions and allow elective and, in certain
 situations,&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-elective&lt;/font&gt;&amp;#xA0;Company
 contributions based on each participant&amp;#x2019;s contribution or a
 specified percentage of eligible wages. Participants may defer a
 percentage of their annual compensation subject to the limits
 defined in the 401(k) Plans. The Company recorded expense of
 $55.8&amp;#xA0;million, $50.7&amp;#xA0;million and $45.2&amp;#xA0;million for
 the years ended December&amp;#xA0;31, 2018, 2017 and 2016,
 respectively, primarily related to the 401(k) Plans.&lt;/p&gt;


 &lt;/div&gt;</us-gaap:PensionAndOtherPostretirementBenefitsDisclosureTextBlock>
  <us-gaap:ProceedsFromIssuanceOfCommonStock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_34">16258000</us-gaap:ProceedsFromIssuanceOfCommonStock>
  <us-gaap:ProceedsFromSaleMaturityAndCollectionsOfInvestments contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_21">13710000</us-gaap:ProceedsFromSaleMaturityAndCollectionsOfInvestments>
  <us-gaap:ProceedsAndExcessTaxBenefitFromSharebasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_6F395465-392B-4EF7-A44E-32EB382B7841_1_1">3700000</us-gaap:ProceedsAndExcessTaxBenefitFromSharebasedCompensation>
  <us-gaap:ProceedsFromIssuanceOfSeniorLongTermDebt contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_29">500000000</us-gaap:ProceedsFromIssuanceOfSeniorLongTermDebt>
  <us-gaap:ProceedsFromLinesOfCredit contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_27">1723500000</us-gaap:ProceedsFromLinesOfCredit>
  <us-gaap:ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_23">22764000</us-gaap:ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets>
  <us-gaap:PropertyPlantAndEquipmentDisclosureTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_2ADE05E3-D0DF-45BA-BBC3-C75AD49DD791_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;5.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Property and Equipment:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Property and equipment consists of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="69%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Building&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;33,189&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;33,024&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Land&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;6,683&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6,683&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Equipment 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;300,981&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;253,453&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;340,853&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;293,160&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Accumulated depreciation&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;(207,816&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;(169,624&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;133,037&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;123,536&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 At December&amp;#xA0;31, 2018 and 2017, property and equipment includes
 medical and other equipment held under capital leases of
 $4.8&amp;#xA0;million and $6.1&amp;#xA0;million, and related accumulated
 depreciation of $4.0&amp;#xA0;million and $4.6&amp;#xA0;million,
 respectively. The Company recorded depreciation expense of
 $38.5&amp;#xA0;million, $33.9&amp;#xA0;million and $29.0&amp;#xA0;million for
 the years ended December&amp;#xA0;31, 2018, 2017 and 2016,
 respectively.&lt;/p&gt;


 &lt;/div&gt;</us-gaap:PropertyPlantAndEquipmentDisclosureTextBlock>
  <us-gaap:RepaymentsOfLinesOfCredit contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_28">2094500000</us-gaap:RepaymentsOfLinesOfCredit>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_14">268629000</us-gaap:ProfitLoss>
  <us-gaap:PropertyPlantAndEquipmentTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_7AA76502-5F54-4799-B4B9-DE3495A5BF48_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Property and equipment consists of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="69%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Building&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;33,189&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;33,024&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Land&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;6,683&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6,683&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Equipment 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;300,981&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;253,453&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;340,853&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;293,160&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Accumulated depreciation&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;(207,816&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;(169,624&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;133,037&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;123,536&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:PropertyPlantAndEquipmentTextBlock>
  <us-gaap:PropertyPlantAndEquipmentPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_F1157D7D-3CCA-4F42-90F8-B0B5CEEDC335_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Property and Equipment&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Property and equipment are recorded at original purchase cost.
 Depreciation of property and equipment is computed using the
 straight-line method over the estimated useful lives of the
 underlying assets. Estimated useful lives are generally 30 years
 for buildings; three to seven years for medical equipment, computer
 equipment, software and furniture; and the lesser of the useful
 life or the remaining lease term for leasehold improvements and
 capital leases. Upon sale or retirement of property and equipment,
 the related cost and accumulated depreciation are eliminated from
 the respective accounts and any resulting gain or loss is included
 in earnings.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:PropertyPlantAndEquipmentPolicyTextBlock>
  <us-gaap:QuarterlyFinancialInformationTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_93CF9DB7-343B-492C-BDD5-DA3D84E43976_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;17.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Selected Quarterly Financial
 Information (Unaudited):&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The following tables set forth a summary of the Company&amp;#x2019;s
 selected quarterly financial information for each of the four
 quarters ended December&amp;#xA0;31, 2018 and 2017 (in thousands,
 except for per share data):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="14" align="center"&gt;&lt;b&gt;2018 Quarters&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;First&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Second&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Third&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Fourth&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net revenue&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;901,857&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;915,918&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;896,652&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;932,696&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Operating expenses:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice salaries and benefits&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;631,830&lt;/td&gt;
 &lt;td valign="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;620,980&lt;/td&gt;
 &lt;td valign="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;625,717&lt;/td&gt;
 &lt;td valign="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;657,061&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice supplies and other operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,655&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;31,833&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,159&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;29,381&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 General and administrative expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;108,776&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;107,908&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;102,905&lt;/td&gt;
 &lt;td valign="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;112,789&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Depreciation and amortization&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,163&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,518&lt;/td&gt;
 &lt;td valign="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;28,709&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;29,891&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;797,424&lt;/td&gt;
 &lt;td valign="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;787,239&lt;/td&gt;
 &lt;td valign="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;787,490&lt;/td&gt;
 &lt;td valign="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;829,122&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income from operations&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;104,433&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;128,679&lt;/td&gt;
 &lt;td valign="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;109,162&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;103,574&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Investment and other income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,464&lt;/td&gt;
 &lt;td valign="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;1,202&lt;/td&gt;
 &lt;td valign="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;1,302&lt;/td&gt;
 &lt;td valign="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;967&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Interest expense&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(19,935&lt;/td&gt;
 &lt;td valign="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;(21,604&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(21,782&lt;/td&gt;
 &lt;td valign="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;(25,448&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Equity in earnings of unconsolidated affiliates&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;1,525&lt;/td&gt;
 &lt;td valign="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;1,257&lt;/td&gt;
 &lt;td valign="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;1,766&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,277&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-operating&lt;/font&gt;&amp;#xA0;expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(16,946&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(19,145&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,714&lt;/td&gt;
 &lt;td valign="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;(22,204&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income before income taxes&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;87,487&lt;/td&gt;
 &lt;td valign="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;109,534&lt;/td&gt;
 &lt;td valign="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;90,448&lt;/td&gt;
 &lt;td valign="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;81,370&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax provision&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(24,059&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(30,122&lt;/td&gt;
 &lt;td valign="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;(24,873&lt;/td&gt;
 &lt;td valign="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;(21,156&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;63,428&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;79,412&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;65,575&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;60,214&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Per common and common equivalent share data (1):&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.68&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.85&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.72&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.69&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.68&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.85&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.72&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.68&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Weighted average common shares:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,859&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,987&lt;/td&gt;
 &lt;td valign="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;90,984&lt;/td&gt;
 &lt;td valign="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;87,810&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,505&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,529&lt;/td&gt;
 &lt;td valign="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;91,359&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;88,258&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" border="0"&gt;
 &lt;tr style="break-inside: avoid"&gt;
 &lt;td valign="top" width="4%" align="left"&gt;(1)&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-TOP: 0pt" align="left"&gt;Basic and diluted per share amounts are computed for
 each of the periods presented. Accordingly, the sum of the
 quarterly per share amounts may not agree with the full year
 amount.&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="14" align="center"&gt;&lt;b&gt;2017 Quarters&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;First&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Second&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Third&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Fourth&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net revenue&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;835,597&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;842,944&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;868,951&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;910,820&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Operating expenses:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice salaries and benefits&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;572,385&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;561,418&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;586,476&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;617,455&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice supplies and other operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27,796&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,872&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;29,497&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;32,353&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 General and administrative expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;103,765&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;103,015&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;101,430&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;108,895&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Depreciation and amortization&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,614&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,735&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,116&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,414&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;729,560&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;721,040&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;742,519&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;785,117&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income from operations&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;106,037&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;121,904&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;126,432&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;125,703&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Investment and other income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;576&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;365&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;235&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,777&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Interest expense&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,752&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,535&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,428&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(19,844&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Equity (loss) in earnings of unconsolidated affiliate&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;797&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;689&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(240&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(294&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-operating&lt;/font&gt;&amp;#xA0;expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(16,379&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,481&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,433&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,361&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income before income taxes&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;89,658&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;104,423&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;107,999&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;108,342&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax (provision) benefit&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(34,967&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(40,725&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(42,119&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27,761&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;54,691&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;63,698&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;65,880&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;136,103&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Per common and common equivalent share data (2):&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.59&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.69&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.71&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.47&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.59&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.69&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.71&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.46&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Weighted average common shares:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,360&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,181&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,589&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,756&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,143&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,812&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,881&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,159&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" border="0"&gt;
 &lt;tr style="break-inside: avoid"&gt;
 &lt;td valign="top" width="4%" align="left"&gt;(2)&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-TOP: 0pt" align="left"&gt;Basic and diluted per share amounts are computed for
 each of the periods presented. Accordingly, the sum of the
 quarterly per share amounts may not agree with the full year
 amount.&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</us-gaap:QuarterlyFinancialInformationTextBlock>
  <us-gaap:RepaymentsOfLongTermCapitalLeaseObligations contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_32">1356000</us-gaap:RepaymentsOfLongTermCapitalLeaseObligations>
  <us-gaap:ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_EC216270-C382-4714-B9B0-543D1F7B6AC3_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The components of the income tax provision (benefit) are as follows
 (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="63%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Federal:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;97,754&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;130,053&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;166,758&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(20,176&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;(63,038&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;15,596&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;77,578&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;67,015&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;182,354&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 State:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,605&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;20,070&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;4,296&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(3,973&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;2,965&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,553&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;22,632&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;23,035&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6,849&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;100,210&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;90,050&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;189,203&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</us-gaap:ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock>
  <us-gaap:ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_57A41B87-43DE-4EA8-85FF-4472596F0D03_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Future minimum lease payments under&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-cancelable&lt;/font&gt;&amp;#xA0;operating
 leases as of December&amp;#xA0;31, 2018 are as follows (in
 thousands):&lt;b&gt;&amp;#xA0;&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="83%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2019&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,824&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2020&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;22,038&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2021&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;17,946&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2022&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;12,708&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2023&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;9,440&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Thereafter&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,522&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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;103,478&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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</us-gaap:ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock>
  <us-gaap:RevenueRecognitionPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_7F545D06-6190-4A23-97D5-812C53A15339_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Revenue Recognition&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 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 GHC
 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-TOP: 12pt; 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 GHC 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-TOP: 12pt; 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 GHC 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-TOP: 12pt; 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-TOP: 12pt; 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-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 Accounts receivable are primarily amounts due under &lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;fee-for-service&lt;/font&gt;&lt;/font&gt; contracts from
 third-party payors, such as insurance companies, self-insured
 employers and patients and GHC Programs geographically dispersed
 throughout the United States and its territories. Concentration of
 credit risk relating to accounts receivable is limited by the
 number, diversity and geographic dispersion of the business units
 managed by the Company, as well as by the large number of patients
 and payors, including the various governmental agencies in the
 states in which the Company provides services. Receivables from
 government agencies made up approximately 19% and 17% of net
 accounts receivable at December&amp;#xA0;31, 2018 and 2017,
 respectively.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:RevenueRecognitionPolicyTextBlock>
  <us-gaap:ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_53705D50-E7FE-4D45-A662-1A054A716D9E_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Accounts payable and accrued expenses consist of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="70%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;31,059&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;34,632&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;249,834&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;225,429&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;80,369&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;75,672&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;34,931&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;37,912&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;18,760&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6,259&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;9,477&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;4,495&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;44,912&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;53,618&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;469,342&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;438,017&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_0">3647123000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_12146CD1-8715-4356-97E6-BFF4D26AD8BA_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Accounts receivable, net consists of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="65%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,031,341&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;(1,489,069&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;542,272&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_4C7ED7A7-3241-4730-B4AB-9236F4A5C0D2_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The differences between the effective rate and the United States
 federal income tax statutory rate are as follows:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Tax at statutory rate&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;21.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;35.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;35.00&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 State income tax, net of federal benefit&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;4.80&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3.33&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2.94&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Non-deductible&lt;/font&gt;&amp;#xA0;expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.44&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.49&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.43&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in accrual estimates relating to uncertain tax positions&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.05&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.02&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(2.11&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in valuation allowance&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.48&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Other, net&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.20&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.16&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.06&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Change in tax law&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(0.32&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17.06&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax provision&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27.17&lt;/td&gt;
 &lt;td valign="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;21.94&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;36.80&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</us-gaap:ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock>
  <us-gaap:ShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_1_5">38703000</us-gaap:ShareBasedCompensation>
  <us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_F65F1E68-68FD-42C7-8149-662B630B4181_1_0">P1Y3M18D</us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2>
  <us-gaap:ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_D2B45BBF-A5C6-413E-A194-CDE6AFBFE25D_1_1">27.38</us-gaap:ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice>
  <us-gaap:SignificantAccountingPoliciesTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_298103C4-2209-4B7F-9D68-E9C34E59DAFB_1_0">&lt;div&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" border="0"&gt;
 &lt;tr style="break-inside: avoid"&gt;
 &lt;td valign="top" width="4%" align="left"&gt;
 &lt;b&gt;2.&amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Summary&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-TOP: 0pt" align="left"&gt;&lt;b&gt;of Significant Accounting Policies:&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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Principles of Presentation&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The consolidated financial statements include all the accounts of
 the Company and its subsidiaries combined with the accounts of the
 affiliated professional contractors with which the Company
 currently has specific management arrangements. The Company&amp;#x2019;s
 agreements with affiliated professional contractors provide that
 the term of the arrangements are in most cases permanent, subject
 only to termination by the Company, except in the case of gross
 negligence, fraud or bankruptcy of the Company. The Company has the
 right to receive income, both as ongoing fees and as proceeds from
 the sale of its interest in the Company&amp;#x2019;s affiliated
 professional contractors, in an amount that fluctuates based on the
 performance of the affiliated professional contractors and the
 change in the fair value of the Company&amp;#x2019;s interest in the
 affiliated professional contractors. The Company has exclusive
 responsibility for the provision of
 all&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-medical&lt;/font&gt;&amp;#xA0;services
 required for the&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;day-to-day&lt;/font&gt;&lt;/font&gt;&amp;#xA0;operation
 and management of the Company&amp;#x2019;s affiliated professional
 contractors and establishes the guidelines for the employment and
 compensation of the physicians. In addition, the agreements provide
 that the Company has the right, but not the obligation, to
 purchase, or to designate a person(s) to purchase, the stock of the
 Company&amp;#x2019;s affiliated professional contractors for a nominal
 amount. Separately, in its sole discretion, the Company has the
 right to assign its interest in the agreements. Based upon the
 provisions of these agreements, the Company has determined that the
 affiliated professional contractors are variable interest entities
 and that the Company is the primary beneficiary as defined in the
 accounting guidance for consolidation. All significant intercompany
 and interaffiliate accounts and transactions have been
 eliminated.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&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.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Recently Adopted Accounting Pronouncements&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&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 the Company&amp;#x2019;s 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.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;New Accounting Pronouncements&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&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 became 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 has
 accumulated all of the necessary information required to properly
 account for leases under the new guidance. The Company has
 implemented a cloud-based software application, inclusive of a
 lease administration module and an accounting module. The Company
 is in the process of finalizing workflows, business processes and
 internal controls surrounding the new lease accounting process in
 order to meet the reporting and disclosure requirements.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Accounting Estimates and Assumptions&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The preparation of financial statements in conformity with
 accounting principles generally accepted in the United States
 (&amp;#x201C;GAAP&amp;#x201D;) requires management to make estimates and
 assumptions that affect the reported amounts of assets and
 liabilities and disclosure of contingent assets and liabilities at
 the date of the financial statements and the reported amounts of
 revenue and expenses during the reporting periods. Significant
 estimates and assumptions are involved in the calculation of the
 Company&amp;#x2019;s allowance for contractual adjustments and
 uncollectibles on accounts receivable, liabilities for self-insured
 amounts and claims incurred but not reported related to the
 Company&amp;#x2019;s professional liability risks and the fair value of
 goodwill. Actual results could differ from those estimates.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Segment Reporting&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The results of the Company&amp;#x2019;s operations are aggregated into a
 single reportable segment for purposes of presenting financial
 information in accordance with the accounting guidance for segment
 reporting.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The following table summarizes the Company&amp;#x2019;s net revenue by
 service line (in percentages):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;
 &lt;b&gt;Years&amp;#xA0;Ended&amp;#xA0;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Neonatology and other pediatric subspecialties&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;36&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;37&lt;/td&gt;
 &lt;td valign="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;39&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Anesthesiology&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&lt;/td&gt;
 &lt;td valign="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;38&lt;/td&gt;
 &lt;td valign="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;39&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Radiology&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;12&lt;/td&gt;
 &lt;td valign="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;8&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Maternal-fetal medicine&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8&lt;/td&gt;
 &lt;td valign="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;8&lt;/td&gt;
 &lt;td valign="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;8&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Management services&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;6&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6&lt;/td&gt;
 &lt;td valign="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;5&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Pediatric cardiology&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3&lt;/td&gt;
 &lt;td valign="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;3&lt;/td&gt;
 &lt;td valign="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;3&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Revenue Recognition&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&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 GHC
 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&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 GHC Programs and third-party
 insurance payors for such services.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 Collection of patient service revenue the Company expects to
 receive is normally a function of providing complete and correct
 billing information to the GHC 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 Accounts receivable are primarily amounts due
 under&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;fee-for-service&lt;/font&gt;&lt;/font&gt;&amp;#xA0;contracts
 from third-party payors, such as insurance companies, self-insured
 employers and patients and GHC Programs geographically dispersed
 throughout the United States and its territories. Concentration of
 credit risk relating to accounts receivable is limited by the
 number, diversity and geographic dispersion of the business units
 managed by the Company, as well as by the large number of patients
 and payors, including the various governmental agencies in the
 states in which the Company provides services. Receivables from
 government agencies made up approximately 19% and 17% of net
 accounts receivable at December&amp;#xA0;31, 2018 and 2017,
 respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Cash and Cash Equivalents&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 Cash equivalents are defined as all highly liquid financial
 instruments with maturities of 90 days or less from the date of
 purchase. The Company&amp;#x2019;s cash equivalents typically consist of
 demand deposits, amounts on deposit in money market accounts, and
 funds invested in overnight repurchase agreements. Cash equivalent
 balances may, at certain times, exceed federally insured
 limits.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 Certain cash equivalents carried by the Company are subject to the
 fair value provisions of the accounting guidance for fair value
 measurements. See &amp;#x201C;Fair Value Measurements&amp;#x201D; below.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Restricted Cash&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 Restricted cash consists of funds in escrow related to a potential
 future payment for contingent consideration for an acquisition
 completed in 2017.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Investments&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&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 five years.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company intends and has the ability to hold its securities to
 maturity, and therefore carries such investments at amortized cost
 in accordance with the provisions of the accounting guidance for
 investments in debt securities.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Property and Equipment&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 Property and equipment are recorded at original purchase cost.
 Depreciation of property and equipment is computed using the
 straight-line method over the estimated useful lives of the
 underlying assets. Estimated useful lives are generally 30 years
 for buildings; three to seven years for medical equipment, computer
 equipment, software and furniture; and the lesser of the useful
 life or the remaining lease term for leasehold improvements and
 capital leases. Upon sale or retirement of property and equipment,
 the related cost and accumulated depreciation are eliminated from
 the respective accounts and any resulting gain or loss is included
 in earnings.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Business Acquisitions&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company accounts for all business acquisitions at fair value
 and expenses acquisition costs as they are incurred. Any
 identifiable assets acquired and liabilities assumed are recognized
 and measured at their respective fair values on the acquisition
 date. If information about facts and circumstances existing as of
 the acquisition date is incomplete at the end of the reporting
 period in which a business acquisition occurs, the Company will
 report provisional amounts for the items for which the accounting
 is incomplete. The measurement period ends once the Company
 receives sufficient information to finalize the fair values;
 however, the period will not exceed one year from the acquisition
 date. Any adjustments to provisional amounts that are identified
 during the measurement period are recognized in the reporting
 period in which the adjustment amounts are determined.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 In connection with certain acquisitions, the Company enters into
 agreements to pay additional amounts in cash or common stock based
 on the achievement of certain performance measures for up to five
 years ending after the acquisition dates. The Company measures this
 contingent consideration at fair value at the acquisition date and
 records such contingent consideration as a liability or equity on
 the Company&amp;#x2019;s Consolidated Balance Sheets on the acquisition
 date. The fair value of each contingent consideration liability is
 remeasured at each reporting period with any change in fair value
 recognized as income or expense within operations in the
 Company&amp;#x2019;s Consolidated Statements of Income. See Note 6 for
 more information on the Company&amp;#x2019;s business acquisitions.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Goodwill and Other Intangible Assets&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company records acquired assets and assumed liabilities at
 their respective fair values under the acquisition method of
 accounting. Goodwill represents the excess of purchase price over
 the fair value of the net assets acquired. Intangible assets with
 finite lives, principally physician and hospital agreements,
 customer relationships, patented technology and trade names, are
 recognized apart from goodwill at the time of acquisition based on
 the contractual-legal and separability criteria established in the
 accounting guidance. Intangible assets with finite lives are
 amortized on either an accelerated basis based on the annual
 undiscounted economic cash flows associated with the particular
 intangible asset or on a straight-line basis over their estimated
 useful lives. Intangible assets with finite lives are amortized
 over periods of one to 20 years.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 Goodwill is tested for impairment at a reporting unit level on at
 least an annual basis in accordance with the subsequent measurement
 provisions of the accounting guidance for goodwill. The Company
 defines a reporting unit based upon its management structure for
 services provided in specific regions of the United States. The
 Company early adopted new accounting guidance in 2017 that requires
 only a single-step quantitative test with any goodwill impairment
 measured as the amount by which a reporting unit&amp;#x2019;s carrying
 value exceeds its fair value. The Company uses income and
 market-based valuation approaches to determine the fair value of
 its reporting units. These approaches focus on discounted cash
 flows and market multiples based on the Company&amp;#x2019;s market
 capitalization to derive the fair value of a reporting unit. The
 Company also considers the economic outlook for the healthcare
 services industry and various other factors during the testing
 process, including hospital and physician contract changes, local
 market developments, changes in third-party payor payments, and
 other publicly available information. The Company completed annual
 impairment tests in the third quarter of each of 2018, 2017 and
 2016 and determined that goodwill was not impaired in any of the
 three years.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Long-Lived Assets&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company is required to evaluate long-lived assets, including
 intangible assets subject to amortization, whenever events or
 changes in circumstances indicate that the carrying value of the
 assets may not be fully recoverable. The recoverability of such
 assets is measured by a comparison of the carrying value of the
 assets to the future undiscounted cash flows before interest
 charges to be generated by the assets. If long-lived assets are
 impaired, the impairment to be recognized is measured as the excess
 of the carrying value over the fair value. Long-lived assets held
 for disposal are reported at the lower of the carrying value or
 fair value less disposal costs. The Company does not believe there
 are any indicators that would require an adjustment to such assets
 or their estimated periods of recovery at December&amp;#xA0;31, 2018
 pursuant to current accounting standards.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Common Stock Repurchases&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company repurchases shares of its common stock as authorized
 from time to time by its Board of Directors. The Company treats
 repurchased shares of its common stock as retired as any
 repurchased shares become authorized but unissued shares. The
 reacquisition cost of repurchased shares is recorded as a reduction
 in the respective components of shareholders&amp;#x2019; equity.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Professional Liability Coverage&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company maintains professional liability insurance policies
 with third-party insurers generally on a claims-made basis, subject
 to deductibles or self-insured retention, exclusions and other
 restrictions. The Company&amp;#x2019;s self-insured retention under its
 professional liability insurance program is maintained primarily
 through a wholly owned captive insurance subsidiary. The Company
 records an estimate of liabilities for self-insured amounts and
 claims incurred but not reported based on an actuarial valuation
 using historical loss information, claim emergence patterns and
 various actuarial assumptions. Liabilities for claims incurred but
 not reported are not discounted.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Income Taxes&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company records deferred income taxes using the liability
 method, whereby deferred tax assets and liabilities are determined
 based on the difference between the financial statement and tax
 bases of assets and liabilities using enacted tax rates in effect
 for the year in which the differences are expected to reverse. If
 it is more likely than not that all or a portion of deferred tax
 assets will not be realized, a valuation allowance is provided
 against such deferred tax assets. In making such determination, the
 Company considers all available positive and negative evidence,
 including future reversals of existing taxable temporary
 differences, projected future taxable
 income,&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;tax-planning&lt;/font&gt;&amp;#xA0;strategies,
 and results of recent operations.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The accounting guidance for uncertain tax positions prescribes a
 recognition threshold and measurement attribute for financial
 statement recognition and measurement of a tax position taken or
 expected to be taken in a tax return. The guidance also requires
 policy disclosures regarding penalties and interest and extensive
 disclosures regarding increases and decreases in uncertain tax
 positions as a result of tax positions taken in a current or prior
 period, settlements with taxing authorities and any lapse of an
 applicable statute of limitations. Additional qualitative
 discussion is required for any tax position that may result in a
 significant increase or decrease in uncertain tax positions within
 a&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;12-month&lt;/font&gt;&amp;#xA0;period from
 the Company&amp;#x2019;s reporting date.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Stock Incentive Plans&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company grants stock-based awards consisting primarily of
 restricted stock to key employees under its Amended and Restated
 2008 Incentive Compensation Plan, as amended. The Company measures
 the cost of employee services received in exchange for stock-based
 awards based on grant-date fair value and allocates the resulting
 compensation expense over the corresponding requisite service
 period using the graded vesting attribution method. The Company
 also performs analyses to estimate forfeitures of stock-based
 awards on an annual basis and adjusts the estimates as necessary
 based on the number of awards that ultimately vest.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Net Income Per Common Share&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 Basic net income per common share is calculated by dividing net
 income by the weighted average number of common shares outstanding
 during the period. Diluted net income per common share is
 calculated by dividing net income by the weighted average number of
 common and potential common shares outstanding during the period.
 Potential common shares consist of outstanding restricted stock,
 deferred stock and stock options and is calculated using the
 treasury stock method. On January&amp;#xA0;1, 2017, the Company adopted
 new accounting guidance that no longer permits the Company to
 include the assumed excess tax benefits related to the potential
 exercise or vesting of its stock-based awards in the treasury stock
 method computation.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Fair Value Measurements&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 In accordance with the accounting guidance for fair value
 measurements and disclosures, the Company carries its money market
 funds included in cash and cash equivalents at fair value. In
 accordance with the three-tier fair value hierarchy under this
 guidance, the Company determined the fair value using quoted market
 prices, a Level&amp;#xA0;1 input as defined under the accounting
 guidance for fair value measurements. At December&amp;#xA0;31, 2018 and
 2017, the Company&amp;#x2019;s money market funds had a fair value of
 $0.5&amp;#xA0;million and $9.2&amp;#xA0;million, respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company also carries the cash surrender value of life insurance
 related to its deferred compensation arrangements at fair value.
 The investments underlying the life insurance contracts consist
 primarily of exchange-traded equity securities and mutual funds
 with quoted prices in active markets. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value using the cash surrender value of the life insurance, a
 Level&amp;#xA0;2 input as defined under the accounting guidance for
 fair value measurements. At December&amp;#xA0;31, 2018 and 2017, the
 Company&amp;#x2019;s cash surrender value of life insurance had a fair
 value of $10.5&amp;#xA0;million and $15.6&amp;#xA0;million,
 respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 In addition, the Company carries its contingent consideration
 liabilities related to acquisitions at fair value. In accordance
 with the three-tier fair value hierarchy, the Company determined
 the fair value of its contingent consideration liabilities using
 the income approach with assumed discount rates and payment
 probabilities. The income approach uses Level&amp;#xA0;3, or
 unobservable inputs as defined under the accounting guidance for
 fair value measurements. At December&amp;#xA0;31, 2018 and 2017, the
 Company&amp;#x2019;s contingent consideration liabilities had a fair
 value of $20.0&amp;#xA0;million and $30.5&amp;#xA0;million, respectively.
 See Note 6 for more information regarding the Company&amp;#x2019;s
 contingent consideration liabilities.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The carrying amounts of cash equivalents, short-term investments,
 accounts receivable and accounts payable and accrued expenses
 approximate fair value due to the short maturities of the
 respective instruments. The carrying values of long-term
 investments, line of credit, variable rate long-term debt and
 capital lease obligations approximate fair value. If the
 Company&amp;#x2019;s investments were measured at fair value, they would
 be categorized as Level&amp;#xA0;2 in the fair value hierarchy. If the
 Company&amp;#x2019;s line of credit was measured at fair value, it would
 be categorized as Level&amp;#xA0;2 in the fair value hierarchy. See
 Note 10 for information regarding the fair value of the
 Company&amp;#x2019;s 5.25% senior unsecured notes due 2023 (the
 &amp;#x201C;2023 Notes&amp;#x201D;) and 6.25% senior unsecured notes due 2027
 (the &amp;#x201C;2027 Notes&amp;#x201D;).&lt;/p&gt;
 &lt;/div&gt;</us-gaap:SignificantAccountingPoliciesTextBlock>
  <us-gaap:ScheduleOfDebtTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_59B4BB3A-E090-441D-BEE7-6F1AEC145C07_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The carrying value of the Company&amp;#x2019;s long-term debt was
 $2.0&amp;#xA0;billion and $1.8&amp;#xA0;billion at December&amp;#xA0;31, 2018
 and 2017, respectively, and consisted of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="56%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31, 2018&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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Principal&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Unamortized&lt;br /&gt;
 Debt&lt;br /&gt;
 Issuance&lt;br /&gt;
 Costs&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Total&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Senior Notes&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;1,250,000&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(15,408&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,234,592&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Revolving line of credit&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;739,500&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;(4,274&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;735,226&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,989,500&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(19,682&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,969,818&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="56%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" 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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Principal&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Unamortized&lt;br /&gt;
 Debt&lt;br /&gt;
 Issuance&lt;br /&gt;
 Costs&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Total&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Senior Notes&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;750,000&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(9,503&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;740,497&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Revolving line of credit&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;1,110,500&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;(4,864&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;1,105,636&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,860,500&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(14,367&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;1,846,133&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:ScheduleOfDebtTableTextBlock>
  <us-gaap:ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_60487345-26A7-46C4-9882-8EA38E2AEA23_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 All of the Company&amp;#x2019;s deferred tax assets and liabilities are
 classified as long-term. The significant components of deferred
 income tax assets and liabilities are as follows (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="69%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Allowance for uncollectible accounts&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;194,876&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;80,056&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Reserves and accruals&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;59,270&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;45,454&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Stock-based compensation&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;9,201&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;7,975&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net operating loss carryforward&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;25,226&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;28,569&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Property and equipment&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&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;685&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 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;1,197&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;970&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred tax assets before valuation allowance&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;289,796&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;163,709&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Less: Valuation allowance&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(2,628&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;(2,615&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Deferred tax assets, net of valuation allowance&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;287,168&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;161,094&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Gross deferred tax liabilities:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Amortization&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(286,552&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;(258,618&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Accounting method changes&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;(109,418&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;(4,150&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Accrual to cash adjustment&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;(39&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;(31,290&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 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;(489&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total deferred tax 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;(396,498&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;(294,058&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net deferred tax liability&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(109,330&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(132,964&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock>
  <us-gaap:ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_D3E90874-AA9B-44CA-9BB6-FFD00E374D30_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The activity related to the Company&amp;#x2019;s restricted stock and
 deferred stock awards and the corresponding weighted average
 grant-date fair values for the year ended December&amp;#xA0;31, 2018
 are as follows:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="68%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Number of&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Shares&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Weighted&lt;br /&gt;
 Average&amp;#xA0;Fair&lt;br /&gt;
 Value&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Non-vested&lt;/font&gt;&amp;#xA0;shares at
 January&amp;#xA0;1, 2018&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;1,041,034&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;60.21&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Awarded&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;770,480&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;51.99&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Forfeited&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;(69,293&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;56.65&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Vested&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(431,368&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;63.57&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: rgb(0,0,0) 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: rgb(0,0,0) 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;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Non-vested&lt;/font&gt;&amp;#xA0;shares at
 December&amp;#xA0;31, 2018&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;1,310,853&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;54.46&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</us-gaap:ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock>
  <us-gaap:ScheduleOfWeightedAverageNumberOfSharesTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_41B3C958-A6FA-412B-AB15-84A73AB3B94B_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The calculation of shares used in the basic and diluted net income
 per share calculation for the years ended December&amp;#xA0;31, 2018,
 2017 and 2016 is as follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="73%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="3%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;91,104&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;92,431&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;92,422&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;502&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;527&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;687&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;91,606&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;92,958&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;93,109&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&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;214&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;107&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&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:ScheduleOfWeightedAverageNumberOfSharesTableTextBlock>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="shares" decimals="INF" id="id_14062202_AE5979A1-5C5C-4795-B5D0-5850CB9AC220_1_2">69293</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod>
  <us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_F65F1E68-68FD-42C7-8149-662B630B4181_1_1">P1Y3M18D</us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1>
  <us-gaap:ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_4DEF8D22-9790-4BD5-9B90-F20771ACDEB8_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Intangible assets, net, consist of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="63%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;December&amp;#xA0;31, 2018&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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Gross&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Accumulated&lt;br /&gt;
 Amortization&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Net&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Physician and hospital agreements&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;376,871&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;(223,589)&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;&amp;#xA0;153,282&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Customer relationships&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;443,300&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;(71,870&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;371,430&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Trade names&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;43,156&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;(4,630&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;38,526&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Patented and other technology&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;47,561&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(22,487&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;25,074&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;910,888&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(322,576)&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;588,312&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="63%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" 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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Gross&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Accumulated&lt;br /&gt;
 Amortization&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Net&lt;br /&gt;
 Carrying&lt;br /&gt;
 Value&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Physician and hospital agreements&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;381,635&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;(203,915)&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;&amp;#xA0;177,720&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Customer relationships&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;443,300&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;(48,837&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;394,463&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Trade names&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;43,156&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;(2,933&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;40,223&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Patented and other technology&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;38,590&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;(11,068&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;27,522&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;906,681&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(266,753)&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;639,928&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock>
  <us-gaap:ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_90218658-A351-4EEF-856F-A86385CC133F_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The amounts due under the terms of the Company&amp;#x2019;s capital
 lease obligations at December&amp;#xA0;31, 2018 are as follows:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="89%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2019&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;253&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2020&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;114&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2021&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;74&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</us-gaap:ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock>
  <us-gaap:ScheduleOfQuarterlyFinancialInformationTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_43E95D27-43C8-47AF-B8D0-A5324B6E0286_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The following tables set forth a summary of the Company&amp;#x2019;s
 selected quarterly financial information for each of the four
 quarters ended December&amp;#xA0;31, 2018 and 2017 (in thousands,
 except for per share data):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="14" align="center"&gt;&lt;b&gt;2018 Quarters&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;First&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Second&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Third&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Fourth&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net revenue&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;901,857&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;915,918&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;896,652&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;932,696&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Operating expenses:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice salaries and benefits&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;631,830&lt;/td&gt;
 &lt;td valign="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;620,980&lt;/td&gt;
 &lt;td valign="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;625,717&lt;/td&gt;
 &lt;td valign="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;657,061&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice supplies and other operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,655&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;31,833&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,159&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;29,381&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 General and administrative expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;108,776&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;107,908&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;102,905&lt;/td&gt;
 &lt;td valign="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;112,789&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Depreciation and amortization&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,163&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,518&lt;/td&gt;
 &lt;td valign="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;28,709&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;29,891&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;797,424&lt;/td&gt;
 &lt;td valign="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;787,239&lt;/td&gt;
 &lt;td valign="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;787,490&lt;/td&gt;
 &lt;td valign="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;829,122&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income from operations&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;104,433&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;128,679&lt;/td&gt;
 &lt;td valign="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;109,162&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;103,574&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Investment and other income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,464&lt;/td&gt;
 &lt;td valign="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;1,202&lt;/td&gt;
 &lt;td valign="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;1,302&lt;/td&gt;
 &lt;td valign="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;967&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Interest expense&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(19,935&lt;/td&gt;
 &lt;td valign="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;(21,604&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(21,782&lt;/td&gt;
 &lt;td valign="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;(25,448&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Equity in earnings of unconsolidated affiliates&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;1,525&lt;/td&gt;
 &lt;td valign="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;1,257&lt;/td&gt;
 &lt;td valign="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;1,766&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,277&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-operating&lt;/font&gt;&amp;#xA0;expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(16,946&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(19,145&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,714&lt;/td&gt;
 &lt;td valign="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;(22,204&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income before income taxes&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;87,487&lt;/td&gt;
 &lt;td valign="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;109,534&lt;/td&gt;
 &lt;td valign="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;90,448&lt;/td&gt;
 &lt;td valign="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;81,370&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax provision&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(24,059&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(30,122&lt;/td&gt;
 &lt;td valign="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;(24,873&lt;/td&gt;
 &lt;td valign="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;(21,156&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;63,428&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;79,412&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;65,575&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;60,214&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Per common and common equivalent share data (1):&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.68&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.85&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.72&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.69&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.68&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.85&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.72&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.68&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Weighted average common shares:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,859&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,987&lt;/td&gt;
 &lt;td valign="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;90,984&lt;/td&gt;
 &lt;td valign="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;87,810&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,505&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,529&lt;/td&gt;
 &lt;td valign="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;91,359&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;88,258&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" border="0"&gt;
 &lt;tr style="break-inside: avoid"&gt;
 &lt;td valign="top" width="4%" align="left"&gt;(1)&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-TOP: 0pt" align="left"&gt;Basic and diluted per share amounts are computed for
 each of the periods presented. Accordingly, the sum of the
 quarterly per share amounts may not agree with the full year
 amount.&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="64%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="2%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="14" align="center"&gt;&lt;b&gt;2017 Quarters&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;First&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Second&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Third&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Fourth&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net revenue&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;835,597&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;842,944&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;868,951&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;910,820&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Operating expenses:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice salaries and benefits&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;572,385&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;561,418&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;586,476&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;617,455&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Practice supplies and other operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27,796&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;30,872&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;29,497&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;32,353&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 General and administrative expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;103,765&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;103,015&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;101,430&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;108,895&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Depreciation and amortization&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,614&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,735&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;25,116&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;26,414&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total operating expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;729,560&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;721,040&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;742,519&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;785,117&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income from operations&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;106,037&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;121,904&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;126,432&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;125,703&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Investment and other income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;576&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;365&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;235&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,777&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Interest expense&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,752&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,535&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,428&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(19,844&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Equity (loss) in earnings of unconsolidated affiliate&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;797&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;689&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(240&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(294&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;non-operating&lt;/font&gt;&amp;#xA0;expenses&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(16,379&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,481&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(18,433&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(17,361&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income before income taxes&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;89,658&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;104,423&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;107,999&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;108,342&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Income tax (provision) benefit&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(34,967&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(40,725&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(42,119&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27,761&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;54,691&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;63,698&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;65,880&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;136,103&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Per common and common equivalent share data (2):&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Net income:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.59&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.69&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.71&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.47&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.59&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.69&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;0.71&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1.46&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Weighted average common shares:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Basic&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,360&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,181&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,589&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,756&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Diluted&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,143&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,812&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;92,881&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;93,159&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" border="0"&gt;
 &lt;tr style="break-inside: avoid"&gt;
 &lt;td valign="top" width="4%" align="left"&gt;(2)&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-TOP: 0pt" align="left"&gt;Basic and diluted per share amounts are computed for
 each of the periods presented. Accordingly, the sum of the
 quarterly per share amounts may not agree with the full year
 amount.&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</us-gaap:ScheduleOfQuarterlyFinancialInformationTableTextBlock>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="shares" decimals="INF" id="id_14062202_AE5979A1-5C5C-4795-B5D0-5850CB9AC220_1_1">770480</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="shares" decimals="INF" id="id_14062202_AE5979A1-5C5C-4795-B5D0-5850CB9AC220_1_3">431368</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5080F253-A8E3-4227-B70D-A0CAED6DE09C_1_0">27400000</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_958A4CD4-6EDD-49A8-968D-37A72B84DCD2_1_3">63.57</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue>
  <us-gaap:ScheduleOfSegmentReportingInformationBySegmentTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_F5A27092-51FD-40D7-9565-3286778510F6_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The following table summarizes the Company&amp;#x2019;s net revenue by
 service line (in percentages):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;
 &lt;b&gt;Years&amp;#xA0;Ended&amp;#xA0;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Neonatology and other pediatric subspecialties&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;36&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;37&lt;/td&gt;
 &lt;td valign="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;39&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Anesthesiology&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&lt;/td&gt;
 &lt;td valign="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;38&lt;/td&gt;
 &lt;td valign="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;39&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Radiology&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;12&lt;/td&gt;
 &lt;td valign="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;8&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Maternal-fetal medicine&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8&lt;/td&gt;
 &lt;td valign="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;8&lt;/td&gt;
 &lt;td valign="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;8&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Management services&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;6&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6&lt;/td&gt;
 &lt;td valign="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;5&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Pediatric cardiology&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3&lt;/td&gt;
 &lt;td valign="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;3&lt;/td&gt;
 &lt;td valign="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;3&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:ScheduleOfSegmentReportingInformationBySegmentTextBlock>
  <us-gaap:ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_A9C8F76A-E0AB-47BC-A802-43F14CB195D2_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The activity and certain other information related to the
 Company&amp;#x2019;s outstanding stock option awards for the year ended
 December&amp;#xA0;31, 2018 are as follows:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="51%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Number&amp;#xA0;of&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Stock&amp;#xA0;Options&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Weighted&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Average&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Exercise&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Price&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Weighted&lt;br /&gt;
 Average&lt;br /&gt;
 Remaining&lt;br /&gt;
 Contractual&lt;br /&gt;
 Term&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;(in years)&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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;Aggregate&lt;br /&gt;
 Intrinsic&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;Value&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;(in&lt;br /&gt;
 millions)&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Outstanding at January&amp;#xA0;1, 2018&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;246,342&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27.51&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Exercised&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(133,366&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;27.38&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"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2.8&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: rgb(0,0,0) 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: rgb(0,0,0) 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;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Outstanding and exercisable at December&amp;#xA0;31, 2018&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;112,976&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;27.65&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;1.3&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;0.7&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: rgb(0,0,0) 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: rgb(0,0,0) 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;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock>
  <us-gaap:SchedulesOfConcentrationOfRiskByRiskFactorTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_5B48E5BE-339D-4659-B650-AA5C914606FA_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The following is a summary of our payor mix, expressed as a
 percentage of net revenue, exclusive of administrative fees and
 revenue related to management services and other, for the periods
 indicated:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;
 &lt;b&gt;Years&amp;#xA0;Ended&amp;#xA0;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;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;70&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;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;%&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;23&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;6&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Private-pay&lt;/font&gt;&amp;#xA0;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;2&lt;/td&gt;
 &lt;td valign="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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:SchedulesOfConcentrationOfRiskByRiskFactorTextBlock>
  <us-gaap:SegmentReportingPolicyPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_7AA59C9C-758A-4DFB-8C84-C2B2D454FA96_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Segment Reporting&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The results of the Company&amp;#x2019;s operations are aggregated into a
 single reportable segment for purposes of presenting financial
 information in accordance with the accounting guidance for segment
 reporting.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The following table summarizes the Company&amp;#x2019;s net revenue by
 service line (in percentages):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;
 &lt;b&gt;Years&amp;#xA0;Ended&amp;#xA0;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Neonatology and other pediatric subspecialties&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;36&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;37&lt;/td&gt;
 &lt;td valign="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;39&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Anesthesiology&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&lt;/td&gt;
 &lt;td valign="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;38&lt;/td&gt;
 &lt;td valign="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;39&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Radiology&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;12&lt;/td&gt;
 &lt;td valign="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;8&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Maternal-fetal medicine&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;8&lt;/td&gt;
 &lt;td valign="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;8&lt;/td&gt;
 &lt;td valign="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;8&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Management services&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;6&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;%&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;6&lt;/td&gt;
 &lt;td valign="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;5&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Pediatric cardiology&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3&lt;/td&gt;
 &lt;td valign="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;3&lt;/td&gt;
 &lt;td valign="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;3&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:SegmentReportingPolicyPolicyTextBlock>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_958A4CD4-6EDD-49A8-968D-37A72B84DCD2_1_2">56.65</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_9CB6A509-EAD0-4AB1-AFD9-A8157CACD7B4_1_0">51.99</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_0BEDD904-2C88-4DA8-A32F-9B4E71FC7DFB_1_0">2800000</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue>
  <dei:TradingSymbol contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_0CF63246-5C62-4C5E-ABB5-878675D9EB53_1_0">MD</dei:TradingSymbol>
  <us-gaap:ShareBasedCompensationOptionAndIncentivePlansPolicy contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_E79DDFA4-87D1-4BEE-BDFB-9CBCDC6D26FC_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Stock Incentive Plans&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The Company grants stock-based awards consisting primarily of
 restricted stock to key employees under its Amended and Restated
 2008 Incentive Compensation Plan, as amended. The Company measures
 the cost of employee services received in exchange for stock-based
 awards based on grant-date fair value and allocates the resulting
 compensation expense over the corresponding requisite service
 period using the graded vesting attribution method. The Company
 also performs analyses to estimate forfeitures of stock-based
 awards on an annual basis and adjusts the estimates as necessary
 based on the number of awards that ultimately vest.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:ShareBasedCompensationOptionAndIncentivePlansPolicy>
  <us-gaap:StateAndLocalIncomeTaxExpenseBenefitContinuingOperations contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_1_5">22632000</us-gaap:StateAndLocalIncomeTaxExpenseBenefitContinuingOperations>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9006_900040">302160000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:SummaryOfIncomeTaxContingenciesTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_E14C5210-E0E4-449D-8A03-A6211C49ADC5_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The following table summarizes the activity related to the
 Company&amp;#x2019;s liability for uncertain tax positions for the years
 ended December&amp;#xA0;31, 2018, 2017 and 2016 (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="66%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Balance at beginning of year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,972&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;9,469&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;18,447&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Increases related to prior year tax positions&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;385&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;2,284&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;301&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Decreases related to prior year tax positions&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;(143&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(3,927&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Increases related to current year tax positions&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,900&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;1,430&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;2,258&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Settlements&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" 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;(5,644&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Decreases related to lapse of statutes of limitation&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(3,072&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;(2,068&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;(1,966&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Balance at end of year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;11,185&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,972&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;9,469&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:SummaryOfIncomeTaxContingenciesTextBlock>
  <us-gaap:StockIssuedDuringPeriodSharesStockOptionsExercised contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="shares" decimals="INF" id="id_14062202_3762BF2C-F2D8-4F6B-B25C-39FCD11E9EE4_1_1">133366</us-gaap:StockIssuedDuringPeriodSharesStockOptionsExercised>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9006_900031">18919000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation>
  <us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_1_1">385000</us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions>
  <us-gaap:UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_1_5">3072000</us-gaap:UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="shares" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_22">91606000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="shares" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_21">91104000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_1_3">2900000</us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions>
  <us-gaap:UnrecognizedTaxBenefitsPeriodIncreaseDecrease contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_6AB14061-8583-435A-96D0-284EFC33E3CD_1_0">200000</us-gaap:UnrecognizedTaxBenefitsPeriodIncreaseDecrease>
  <us-gaap:UseOfEstimates contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_B6F1102F-C048-4127-B74B-C080E5886127_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Accounting Estimates and Assumptions&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The preparation of financial statements in conformity with
 accounting principles generally accepted in the United States
 (&amp;#x201C;GAAP&amp;#x201D;) requires management to make estimates and
 assumptions that affect the reported amounts of assets and
 liabilities and disclosure of contingent assets and liabilities at
 the date of the financial statements and the reported amounts of
 revenue and expenses during the reporting periods. Significant
 estimates and assumptions are involved in the calculation of the
 Company&amp;#x2019;s allowance for contractual adjustments and
 uncollectibles on accounts receivable, liabilities for self-insured
 amounts and claims incurred but not reported related to the
 Company&amp;#x2019;s professional liability risks and the fair value of
 goodwill. Actual results could differ from those estimates.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:UseOfEstimates>
  <md:AccruedProfessionalLiabilitiesAssumedThroughAcquisition contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_1_1">1276000</md:AccruedProfessionalLiabilitiesAssumedThroughAcquisition>
  <md:PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_4E821083-0981-419D-A879-1B645A1175E9_1_1">1200000</md:PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions>
  <md:IncomeTaxExpenseForExcessTaxDeficiencies contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_98BCFEDA-A07E-4A42-AD88-CDB7C51CB46B_1_1">1400000</md:IncomeTaxExpenseForExcessTaxDeficiencies>
  <md:ProvisionAdjustmentForLossesRelatedToPriorYear contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_1_3">10299000</md:ProvisionAdjustmentForLossesRelatedToPriorYear>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_3">122028000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:MalpracticeLossContingencyProvisionForLosses contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_1_4">44782000</md:MalpracticeLossContingencyProvisionForLosses>
  <md:ProvisionAdjustmentForLossesRelatedToCurrentYear contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_1_2">34483000</md:ProvisionAdjustmentForLossesRelatedToCurrentYear>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_1_2">2535588000</md:PracticeSalariesAndBenefits>
  <md:CashAndCashEquivalentsMaturityDescription contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_FF17202F-0A86-4DF2-A9AA-A751E528B6A0_1_0">90</md:CashAndCashEquivalentsMaturityDescription>
  <md:NumberOfPhysicianGroupPracticesAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="Company" decimals="INF" id="id_14062202_220D11CA-8D47-495C-9908-30B86EDD7E63_1_0">9</md:NumberOfPhysicianGroupPracticesAcquired>
  <md:NumberOfPediatricSubspecialtyPracticesAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="Company" decimals="INF" id="id_14062202_220D11CA-8D47-495C-9908-30B86EDD7E63_1_2">2</md:NumberOfPediatricSubspecialtyPracticesAcquired>
  <md:NumberOfRadiologyPracticesAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="Company" decimals="INF" id="id_14062202_220D11CA-8D47-495C-9908-30B86EDD7E63_1_3">5</md:NumberOfRadiologyPracticesAcquired>
  <md:NumberOfNeonatologyPracticesAcquired contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="Company" decimals="INF" id="id_14062202_220D11CA-8D47-495C-9908-30B86EDD7E63_1_1">2</md:NumberOfNeonatologyPracticesAcquired>
  <md:BusinessCombinationContingentConsiderationArrangementsTimePeriod contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_AFF4E277-A3E2-4D22-BC0A-78C520B842A5_1_0">P5Y</md:BusinessCombinationContingentConsiderationArrangementsTimePeriod>
  <md:AccountsReceivableAndNetRevenueDisclosureTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_F4C46EE8-77BE-410A-93E9-1DDDBC64333E_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;4. &amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Accounts Receivable and Net
 Revenue:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Accounts receivable, net consists of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="65%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,031,341&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;(1,489,069&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;542,272&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Net revenue consists of the following (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="55%"&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: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;3,067,784&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;2,915,648&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;2,760,192&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;363,369&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;315,778&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;271,886&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;215,970&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;226,886&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;151,081&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;&amp;#xA0;3,647,123&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;3,458,312&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;&amp;#xA0;3,183,159&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 1px"&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The following is a summary of our payor mix, expressed as a
 percentage of net revenue, exclusive of administrative fees and
 revenue related to management services and other, for the periods
 indicated:&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="75%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;
 &lt;b&gt;Years&amp;#xA0;Ended&amp;#xA0;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;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;70&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;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;%&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;23&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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;6&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Private-pay&lt;/font&gt;&amp;#xA0;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;2&lt;/td&gt;
 &lt;td valign="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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; 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;/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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Accounts receivable of $542.3&amp;#xA0;million and $504.0&amp;#xA0;million
 at December&amp;#xA0;31, 2018 and 2017, respectively, consist primarily
 of amounts due from GHC Programs and third-party insurance payors
 for services provided by the Company&amp;#x2019;s affiliated
 physicians.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Net revenue of $3.6&amp;#xA0;billion, $3.5&amp;#xA0;billion and
 $3.2&amp;#xA0;billion for the years ended December&amp;#xA0;31, 2018, 2017
 and 2016, respectively, consists primarily of gross billed charges
 for services provided by the Company&amp;#x2019;s affiliated physicians
 less an estimated allowance for contractual adjustments and
 uncollectibles to properly account for the anticipated differences
 between gross billed charge amounts and expected reimbursement
 amounts.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company&amp;#x2019;s contractual adjustments and uncollectibles as a
 percentage of gross patient service revenue vary slightly each year
 depending on several factors, including improved managed care
 contracting, changes in reimbursement from state Medicaid programs
 and other GHC Programs, shifts in the percentage of patient
 services being reimbursed under GHC Programs and annual price
 increases.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company&amp;#x2019;s annual price increases typically increase
 contractual adjustments as a percentage of gross patient service
 revenue. This increase is primarily due to Medicaid, Medicare and
 other GHC Programs that generally provide for reimbursements on
 a&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;fee-schedule&lt;/font&gt;&amp;#xA0;basis
 rather than on a gross charge basis. When the Company bills these
 programs, like other payors, on a gross-charge basis, it also
 increases its provision for contractual adjustments and
 uncollectibles by the amount of any price increase, resulting in a
 higher contractual adjustment percentage.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&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: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&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;/div&gt;</md:AccountsReceivableAndNetRevenueDisclosureTextBlock>
  <md:ProfessionalLiabilityCoveragePolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_6639FDDE-3A73-4644-8351-70BE0D43CDF4_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Professional Liability Coverage&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The Company maintains professional liability insurance policies
 with third-party insurers generally on a claims-made basis, subject
 to deductibles or self-insured retention, exclusions and other
 restrictions. The Company&amp;#x2019;s self-insured retention under its
 professional liability insurance program is maintained primarily
 through a wholly owned captive insurance subsidiary. The Company
 records an estimate of liabilities for self-insured amounts and
 claims incurred but not reported based on an actuarial valuation
 using historical loss information, claim emergence patterns and
 various actuarial assumptions. Liabilities for claims incurred but
 not reported are not discounted.&lt;/p&gt;
 &lt;/div&gt;</md:ProfessionalLiabilityCoveragePolicyTextBlock>
  <md:CommonStockRepurchasesTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_6DC6BE42-F919-47AF-A89A-2D8A1DCF4C25_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &lt;b&gt;14. &amp;#xA0;&amp;#xA0;&amp;#xA0;&amp;#xA0;Common Stock Repurchase
 Programs:&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&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&amp;#xA0;&lt;font style="WHITE-SPACE: nowrap"&gt;&lt;font style="WHITE-SPACE: nowrap"&gt;time-to-time&lt;/font&gt;&lt;/font&gt;&amp;#xA0;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. 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.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 In August 2018, the Company announced that its Board of Directors
 had authorized the repurchase of up to $500.0&amp;#xA0;million of the
 Company&amp;#x2019;s common stock in addition to its existing share
 repurchase program. As part of this repurchase program, on
 August&amp;#xA0;31, 2018, the Company entered into an uncollared
 accelerated share repurchase (&amp;#x201C;ASR&amp;#x201D;) agreement with an
 investment bank. Under the ASR agreement, the Company agreed to
 purchase $250.0&amp;#xA0;million of its common stock in total. On
 September&amp;#xA0;4, 2018, the Company paid a total of
 $250.0&amp;#xA0;million to the investment bank, which in turn delivered
 to the Company approximately 4.2&amp;#xA0;million shares of the
 Company&amp;#x2019;s common stock in total based on the market price of
 a share of Company common stock on August&amp;#xA0;31, 2018. The
 payment was recorded as a reduction to the respective components of
 shareholders&amp;#x2019; equity. The ASR agreement was funded by
 borrowings under the Company&amp;#x2019;s Credit Agreement discussed in
 Note 10. Final settlement of the ASR occurred in December 2018 with
 the delivery to the Company of approximately 1.7&amp;#xA0;million
 additional shares of common stock. The final number of shares of
 common stock that the Company received was based upon the average
 daily volume weighted-average price of the Company&amp;#x2019;s common
 stock during the term of the ASR agreement, less a negotiated
 discount.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 Under the share repurchase programs described above, the Company
 repurchased approximately 7.0&amp;#xA0;million shares of its common
 stock for approximately $302.2&amp;#xA0;million during the year ended
 December&amp;#xA0;31, 2018, 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 exercises of stock options during the second quarter of
 2018.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 During the year ended December&amp;#xA0;31, 2017, the Company
 repurchased 1.0&amp;#xA0;million shares of its common stock for
 $70.2&amp;#xA0;million, inclusive of 38,257 shares withheld to satisfy
 minimum statutory withholding obligations of $2.1&amp;#xA0;million in
 connection with the vesting of restricted stock.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company intends to utilize various methods to effect any future
 share repurchases, including, among others, open market purchases
 and accelerated share repurchase programs. The amount and timing of
 repurchases will depend upon several factors, including general
 economic and market conditions and trading restrictions.&lt;/p&gt;


 &lt;/div&gt;</md:CommonStockRepurchasesTextBlock>
  <md:CommonStockShareRepurchasesPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_4674A690-274F-4BDE-90CA-7A40338AA87E_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 &lt;b&gt;Common Stock Repurchases&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal"&gt;
 The Company repurchases shares of its common stock as authorized
 from time to time by its Board of Directors. The Company treats
 repurchased shares of its common stock as retired as any
 repurchased shares become authorized but unissued shares. The
 reacquisition cost of repurchased shares is recorded as a reduction
 in the respective components of shareholders&amp;#x2019; equity.&lt;/p&gt;


 &lt;/div&gt;</md:CommonStockShareRepurchasesPolicyTextBlock>
  <md:RecentlyAdoptedAccountingPronouncementsPolicyTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_FAF8FD31-733E-4FB6-9CA5-81D0D2EA268A_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"&gt;
 &lt;b&gt;Recently Adopted Accounting Pronouncements&lt;/b&gt;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 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 the Company&amp;#x2019;s 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.&lt;/p&gt;
 &lt;/div&gt;</md:RecentlyAdoptedAccountingPronouncementsPolicyTextBlock>
  <md:ScheduleOfAccruedProfessionalLiabilityTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_749DA8AC-C4A4-446B-9158-60638659E01F_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The activity related to the Company&amp;#x2019;s total accrued
 professional liability for the years ended December&amp;#xA0;31, 2018,
 2017 and 2016 is as follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="63%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="5%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="4%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"&gt;&lt;b&gt;Years Ended
 December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"&gt;&lt;b&gt;2016&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Balance at beginning of year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;250,187&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;202,052&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;202,527&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Assumed liabilities through acquisition&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;1,276&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;20,716&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Provision (adjustment) for losses related to:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;34,483&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;41,291&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;38,129&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Prior 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;10,299&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;9,983&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;(25,428&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total provision for losses&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;44,782&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;51,274&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;12,701&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Claim payments related to:&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Current year&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;(555&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;(712&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;(766&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Prior 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;(51,699&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;(23,143&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;)&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;(12,410&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Total payments&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;(52,254&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;(23,855&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;(13,176&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Balance at end of year&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;243,991&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;250,187&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;202,052&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:ScheduleOfAccruedProfessionalLiabilityTableTextBlock>
  <md:ScheduleOfCapitalLeaseObligationsTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_2D628D75-BB5B-4440-B215-159AE5084FD9_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The Company&amp;#x2019;s capital lease obligations consist of the
 following (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="76%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="8%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="7%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Capital lease obligations&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;441&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,826&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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Less: Current portion&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;(253&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;(1,401&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 Long-term portion&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;188&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;425&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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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:ScheduleOfCapitalLeaseObligationsTableTextBlock>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_1_4">1.00</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:SummaryOfEstimatedFairValueOfNotesTableTextBlock contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" id="id_14062202_43EE7040-EC32-4EAB-818E-24D1685A3EFA_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 The estimated fair value of the Company&amp;#x2019;s 2023 Notes and 2027
 Notes were estimated using trading prices as of December&amp;#xA0;31,
 2018 and 2017, respectively, as Level&amp;#xA0;2 inputs to estimate
 fair value and are summarized as follows (in thousands):&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="70%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="6%"&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;td&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;December&amp;#xA0;31,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 8pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid" bgcolor="#CCEEFF"&gt;
 &lt;td valign="top"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2023 Notes&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;736,725&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;763,125&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; break-inside: avoid"&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &amp;quot;Times New Roman&amp;quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em"&gt;
 2027 Notes&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;482,500&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;b&gt;&amp;#xA0;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap" align="right"&gt;
 &lt;b&gt;&amp;#x2014;&amp;#xA0;&amp;#xA0;&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&lt;b&gt;&amp;#xA0;&lt;/b&gt;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;


 &lt;/div&gt;</md:SummaryOfEstimatedFairValueOfNotesTableTextBlock>
  <md:StockIssuedDuringPeriodValueStockSwaps contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9006_900036">-2661000</md:StockIssuedDuringPeriodValueStockSwaps>
  <md:IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_CBF6AE6C-F1B7-463C-B899-2D2F890066C2_1_0">114800000</md:IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts>
  <md:IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_CBF6AE6C-F1B7-463C-B899-2D2F890066C2_1_2">31300000</md:IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3064218x3069261" id="id_14062202_1912388D-008E-40DF-BD21-3FB677F5C41F_1002_1">P3Y</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1>
  <us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3064218x3069261_3078512x3074821" id="id_14062202_1912388D-008E-40DF-BD21-3FB677F5C41F_2002_2">P10Y</us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3064218x3079518" id="id_14062202_1912388D-008E-40DF-BD21-3FB677F5C41F_3002_3">P3Y</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1>
  <us-gaap:EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3064218x3291163" id="id_14062202_73BAE092-579B-4BFA-B702-3EA09F95D8B3_1001_0">P1Y4M24D</us-gaap:EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1>
  <us-gaap:GoodwillPurchaseAccountingAdjustments contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3064719x3302268" unitRef="iso4217_USD" decimals="-5" id="id_14062202_F93F9858-1151-43D2-A889-77EA97D29B6B_1001_3">4000000</us-gaap:GoodwillPurchaseAccountingAdjustments>
  <us-gaap:PaymentsToAcquireBusinessesGross contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3064719x3302268" unitRef="iso4217_USD" decimals="-5" id="id_14062202_F93F9858-1151-43D2-A889-77EA97D29B6B_1001_4">1500000</us-gaap:PaymentsToAcquireBusinessesGross>
  <us-gaap:GoodwillAcquiredDuringPeriod contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3064719x3321594" unitRef="iso4217_USD" decimals="-5" id="id_14062202_220D11CA-8D47-495C-9908-30B86EDD7E63_1001_5">95000000</us-gaap:GoodwillAcquiredDuringPeriod>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3063975_3065618x3071754" unitRef="pure" decimals="2" id="id_14062202_B11296A4-C34A-4A53-A695-71FB262F71D8_1001_0">0.19</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245" unitRef="pure" decimals="INF" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_1001_6">1.00</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3073813" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_2001_4">0.06</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3245705" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_3001_2">0.12</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3253054" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_4001_0">0.36</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3253055" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_5001_1">0.35</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3253056" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_6001_3">0.08</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3317063" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_7001_5">0.03</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:DebtInstrumentMaturityDateDescription contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3297729" id="id_14062202_88F8ACFD-9463-4F4F-928E-5314380120AB_4_2">Payable semi-annually in arrears on June 1 and December 1</us-gaap:DebtInstrumentMaturityDateDescription>
  <md:DebtInstrumentMaturityYear contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3297729" id="id_14062202_A23B208D-AC4E-4DC1-B4C5-330A8D81226E_1001_1">2023</md:DebtInstrumentMaturityYear>
  <us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3297729_3066719x3066089" unitRef="pure" decimals="5" id="id_14062202_64B2B3F5-161F-418D-BCD9-595F10C10DB7_1001_1">1.01313</us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed>
  <us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3297729_3066719x3066721" unitRef="pure" decimals="5" id="id_14062202_64B2B3F5-161F-418D-BCD9-595F10C10DB7_2001_0">1.02625</us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed>
  <us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3297729_3066719x3279121" unitRef="pure" decimals="INF" id="id_14062202_64B2B3F5-161F-418D-BCD9-595F10C10DB7_3001_2">1.00</us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed>
  <us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3297729_3076720x3252743" unitRef="pure" decimals="INF" id="id_14062202_A23B208D-AC4E-4DC1-B4C5-330A8D81226E_2001_0">1.01</us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed>
  <us-gaap:DebtInstrumentMaturityDateDescription contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202" id="id_14062202_88F8ACFD-9463-4F4F-928E-5314380120AB_3_2">Payable semi-annually in arrears on January 15 and July 15</us-gaap:DebtInstrumentMaturityDateDescription>
  <md:DebtInstrumentMaturityYear contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202" id="id_14062202_A23B208D-AC4E-4DC1-B4C5-330A8D81226E_3001_3">2027</md:DebtInstrumentMaturityYear>
  <us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3066088" unitRef="pure" decimals="5" id="id_14062202_8A7CA25F-A358-4C7B-8E36-2D3541F84CD8_1001_3">1.04688</us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed>
  <us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3066314" unitRef="pure" decimals="5" id="id_14062202_8A7CA25F-A358-4C7B-8E36-2D3541F84CD8_2001_4">1.03125</us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed>
  <us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3066720" unitRef="pure" decimals="5" id="id_14062202_8A7CA25F-A358-4C7B-8E36-2D3541F84CD8_3001_5">1.01563</us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed>
  <us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3255258" unitRef="pure" decimals="INF" id="id_14062202_8A7CA25F-A358-4C7B-8E36-2D3541F84CD8_4001_6">1.00</us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed>
  <us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3538549" unitRef="pure" decimals="INF" id="id_14062202_8A7CA25F-A358-4C7B-8E36-2D3541F84CD8_5001_0">1.00</us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed>
  <us-gaap:DebtInstrumentRedemptionPricePercentage contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3538549_3081295x3332561" unitRef="pure" decimals="5" id="id_14062202_8A7CA25F-A358-4C7B-8E36-2D3541F84CD8_6001_2">1.06250</us-gaap:DebtInstrumentRedemptionPricePercentage>
  <us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3538549_3081295x3332561" unitRef="pure" decimals="2" id="id_14062202_8A7CA25F-A358-4C7B-8E36-2D3541F84CD8_6001_1">0.35</us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed>
  <us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3076720x3252743" unitRef="pure" decimals="INF" id="id_14062202_A23B208D-AC4E-4DC1-B4C5-330A8D81226E_4001_2">1.01</us-gaap:DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed>
  <us-gaap:DebtInstrumentDescriptionOfVariableRateBasis contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066061x3320305_3082302x3069706" id="id_14062202_3D4C2F91-0A2D-4617-8F57-90B439E45B66_1001_0">Federal Funds Rate plus 1/2 of 1.00%</us-gaap:DebtInstrumentDescriptionOfVariableRateBasis>
  <us-gaap:DebtInstrumentBasisSpreadOnVariableRate1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066061x3320305_3082302x3074465" unitRef="pure" decimals="INF" id="id_14062202_3D4C2F91-0A2D-4617-8F57-90B439E45B66_2001_1">0.0100</us-gaap:DebtInstrumentBasisSpreadOnVariableRate1>
  <us-gaap:DebtInstrumentDescriptionOfVariableRateBasis contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066061x3320305_3082302x3074465" id="id_14062202_3D4C2F91-0A2D-4617-8F57-90B439E45B66_2001_2">LIBOR  for an interest period of one month plus 1.00%</us-gaap:DebtInstrumentDescriptionOfVariableRateBasis>
  <us-gaap:DebtInstrumentBasisSpreadOnVariableRate1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066061x3334909_3078512x3074821_3082302x3074465" unitRef="pure" decimals="INF" id="id_14062202_3D4C2F91-0A2D-4617-8F57-90B439E45B66_3001_4">0.00750</us-gaap:DebtInstrumentBasisSpreadOnVariableRate1>
  <us-gaap:DebtInstrumentBasisSpreadOnVariableRate1 contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3066061x3334909_3078512x3075282_3082302x3074465" unitRef="pure" decimals="INF" id="id_14062202_3D4C2F91-0A2D-4617-8F57-90B439E45B66_4001_3">0.00125</us-gaap:DebtInstrumentBasisSpreadOnVariableRate1>
  <us-gaap:AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3070943x3294255" id="id_14062202_E248977C-23F7-45C4-8AD2-68E3BCBBB7B9_1001_1">P9Y</us-gaap:AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3071347x3071755" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_1001_1">0.24</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3071347x3080487" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_2001_3">0.02</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3071347x3081046" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_3001_2">0.04</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3071347x3281104" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_4001_0">0.70</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3076363x3266135" unitRef="pure" decimals="2" id="id_14062202_3E3B4EDC-0A2B-408D-964F-5E1102699D8C_1001_1">0.90</us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent>
  <us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3076363x3271447" unitRef="pure" decimals="2" id="id_14062202_3E3B4EDC-0A2B-408D-964F-5E1102699D8C_2001_0">0.85</us-gaap:SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent>
  <us-gaap:StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3076363x3384934" unitRef="shares" decimals="INF" id="id_14062202_25C8A35A-F4B1-4F0E-BD5C-BCDD3F94FBF3_1001_1">400000</us-gaap:StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3077210x3071532" unitRef="iso4217_USD" decimals="-3" id="id_14062202_04DF90CB-17A0-49B6-80F6-CCFE1209913A_1001_1">3067784000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3077210x3073813" unitRef="iso4217_USD" decimals="-3" id="id_14062202_04DF90CB-17A0-49B6-80F6-CCFE1209913A_2001_3">215970000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3077210x3296576" unitRef="iso4217_USD" decimals="-3" id="id_14062202_04DF90CB-17A0-49B6-80F6-CCFE1209913A_3001_2">363369000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:PropertyPlantAndEquipmentUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3064276" id="id_14062202_5C688E6F-FF58-4C94-9ADC-2BB9C4291B69_1001_0">P30Y</us-gaap:PropertyPlantAndEquipmentUsefulLife>
  <us-gaap:PropertyPlantAndEquipmentUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3065616_3078512x3074821" id="id_14062202_5C688E6F-FF58-4C94-9ADC-2BB9C4291B69_2001_4">P7Y</us-gaap:PropertyPlantAndEquipmentUsefulLife>
  <us-gaap:PropertyPlantAndEquipmentUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3065616_3078512x3075282" id="id_14062202_5C688E6F-FF58-4C94-9ADC-2BB9C4291B69_3001_3">P3Y</us-gaap:PropertyPlantAndEquipmentUsefulLife>
  <us-gaap:PropertyPlantAndEquipmentUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3068864_3078512x3074821" id="id_14062202_5C688E6F-FF58-4C94-9ADC-2BB9C4291B69_4001_2">P7Y</us-gaap:PropertyPlantAndEquipmentUsefulLife>
  <us-gaap:PropertyPlantAndEquipmentUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3068864_3078512x3075282" id="id_14062202_5C688E6F-FF58-4C94-9ADC-2BB9C4291B69_5001_1">P3Y</us-gaap:PropertyPlantAndEquipmentUsefulLife>
  <us-gaap:PropertyPlantAndEquipmentUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3070568_3078512x3074821" id="id_14062202_5C688E6F-FF58-4C94-9ADC-2BB9C4291B69_6001_8">P7Y</us-gaap:PropertyPlantAndEquipmentUsefulLife>
  <us-gaap:PropertyPlantAndEquipmentUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3070568_3078512x3075282" id="id_14062202_5C688E6F-FF58-4C94-9ADC-2BB9C4291B69_7001_7">P3Y</us-gaap:PropertyPlantAndEquipmentUsefulLife>
  <us-gaap:PropertyPlantAndEquipmentUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3081128_3078512x3074821" id="id_14062202_5C688E6F-FF58-4C94-9ADC-2BB9C4291B69_8001_6">P7Y</us-gaap:PropertyPlantAndEquipmentUsefulLife>
  <us-gaap:PropertyPlantAndEquipmentUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3081128_3078512x3075282" id="id_14062202_5C688E6F-FF58-4C94-9ADC-2BB9C4291B69_9001_5">P3Y</us-gaap:PropertyPlantAndEquipmentUsefulLife>
  <us-gaap:FiniteLivedIntangibleAssetUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078512x3074821" id="id_14062202_A28EDA4A-F6C9-4A9F-B210-5BE04D1B2E79_1001_1">P20Y</us-gaap:FiniteLivedIntangibleAssetUsefulLife>
  <us-gaap:LineOfCreditFacilityCommitmentFeePercentage contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078512x3074821" unitRef="pure" decimals="INF" id="id_14062202_3D4C2F91-0A2D-4617-8F57-90B439E45B66_5001_6">0.00300</us-gaap:LineOfCreditFacilityCommitmentFeePercentage>
  <md:NetOperatingLossCarryForwardsExpirationDate contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078512x3074821" id="id_14062202_534D1136-F996-4605-A930-CB1498AA2308_5_1">2038</md:NetOperatingLossCarryForwardsExpirationDate>
  <md:LongTermInvestmentsMaturityPeriod contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078512x3074821" id="id_14062202_B5A6F494-B1CF-428F-9952-241A993BE173_1_0">P5Y</md:LongTermInvestmentsMaturityPeriod>
  <md:ShortTermInvestmentMaturityPeriod contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078512x3074821" id="id_14062202_B5A6F494-B1CF-428F-9952-241A993BE173_1_1">P1Y</md:ShortTermInvestmentMaturityPeriod>
  <us-gaap:FiniteLivedIntangibleAssetUsefulLife contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078512x3075282" id="id_14062202_A28EDA4A-F6C9-4A9F-B210-5BE04D1B2E79_2001_0">P1Y</us-gaap:FiniteLivedIntangibleAssetUsefulLife>
  <us-gaap:LineOfCreditFacilityCommitmentFeePercentage contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078512x3075282" unitRef="pure" decimals="INF" id="id_14062202_3D4C2F91-0A2D-4617-8F57-90B439E45B66_6001_5">0.00150</us-gaap:LineOfCreditFacilityCommitmentFeePercentage>
  <md:NetOperatingLossCarryForwardsExpirationDate contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078512x3075282" id="id_14062202_534D1136-F996-4605-A930-CB1498AA2308_4_1">2019</md:NetOperatingLossCarryForwardsExpirationDate>
  <md:LongTermInvestmentsMaturityPeriod contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3078512x3075282" id="id_14062202_B5A6F494-B1CF-428F-9952-241A993BE173_2_0">P1Y</md:LongTermInvestmentsMaturityPeriod>
  <us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9003_600035">38703000</us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9003_600033">-8000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9003_600040">79631000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9003_600038">-1000</us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9003_600031">18914000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation>
  <md:StockIssuedDuringPeriodValueStockSwaps contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9003_600036">-2660000</md:StockIssuedDuringPeriodValueStockSwaps>
  <us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensationGross contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9001_400034">770000</us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensationGross>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9001_500033">8000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9001_500040">70000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9001_400039">-69000</us-gaap:StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited>
  <us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9001_400032">495000</us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensation>
  <us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9001_500038">1000</us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9001_500031">5000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation>
  <us-gaap:StockRepurchasedDuringPeriodShares contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9001_400041">7041000</us-gaap:StockRepurchasedDuringPeriodShares>
  <md:StockIssuedDuringPeriodSharesStockSwaps contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9001_400037">-56000</md:StockIssuedDuringPeriodSharesStockSwaps>
  <md:StockIssuedDuringPeriodValueStockSwaps contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9001_500036">-1000</md:StockIssuedDuringPeriodValueStockSwaps>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3078149" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9004_700030">268629000</us-gaap:ProfitLoss>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3078149" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_9004_700040">222459000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:OpenTaxYear contextRef="eol_PE10840---1810-K0015_STD_365_20181231_0_3081022x3068238" id="id_14062202_04F47F65-900D-4C1E-8CF1-25F398703974_1_0">2014</us-gaap:OpenTaxYear>
  <us-gaap:UnrecognizedTaxBenefitsPeriodIncreaseDecrease contextRef="eol_PE10840---1810-K0015_STD_365_20191231_0_3081295x3078919" unitRef="iso4217_USD" decimals="-5" id="id_14062202_6AB14061-8583-435A-96D0-284EFC33E3CD_3_0">200000</us-gaap:UnrecognizedTaxBenefitsPeriodIncreaseDecrease>
  <us-gaap:AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4006_900013">4131000</us-gaap:AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation>
  <us-gaap:AllocatedShareBasedCompensationExpense contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5DD587BB-0B66-4963-A269-D923B9E5F198_3_0">34000000</us-gaap:AllocatedShareBasedCompensationExpense>
  <us-gaap:AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="shares" decimals="-3" id="id_14062202_5D948726-9D47-457B-BD6D-63332D0C9B24_3_3">2000</us-gaap:AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount>
  <us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4006_900008">34000000</us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue>
  <us-gaap:AmortizationOfFinancingCostsAndDiscounts contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_4">4816000</us-gaap:AmortizationOfFinancingCostsAndDiscounts>
  <us-gaap:AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_98BCFEDA-A07E-4A42-AD88-CDB7C51CB46B_3_0">4200000</us-gaap:AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet>
  <us-gaap:AmortizationOfIntangibleAssets contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_23B92773-CA4C-435B-A91C-A85F548D9201_3_0">60300000</us-gaap:AmortizationOfIntangibleAssets>
  <us-gaap:CapitalExpendituresIncurredButNotYetPaid contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_48">2673000</us-gaap:CapitalExpendituresIncurredButNotYetPaid>
  <us-gaap:CapitalLeaseObligationsIncurred contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_47">1619000</us-gaap:CapitalLeaseObligationsIncurred>
  <us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_38">4126000</us-gaap:CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect>
  <us-gaap:CurrentFederalTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_3_0">166758000</us-gaap:CurrentFederalTaxExpenseBenefit>
  <us-gaap:CurrentStateAndLocalTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_3_3">4296000</us-gaap:CurrentStateAndLocalTaxExpenseBenefit>
  <us-gaap:DeferredFederalIncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_3_1">15596000</us-gaap:DeferredFederalIncomeTaxExpenseBenefit>
  <us-gaap:DeferredIncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_6">18149000</us-gaap:DeferredIncomeTaxExpenseBenefit>
  <us-gaap:DeferredStateAndLocalIncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_3_4">2553000</us-gaap:DeferredStateAndLocalIncomeTaxExpenseBenefit>
  <us-gaap:Depreciation contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5AB7E65F-6B18-4C0B-979C-191C7614027B_3_2">29000000</us-gaap:Depreciation>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_5">89264000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:DefinedContributionPlanCostRecognized contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_99CF5A6E-BE3D-4251-BDB1-4F0036EE4DA6_3_0">45200000</us-gaap:DefinedContributionPlanCostRecognized>
  <us-gaap:EffectiveIncomeTaxRateContinuingOperations contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="pure" decimals="4" id="id_14062202_825CA47E-8C6C-4752-B30C-4D0591235E93_3_1">0.3680</us-gaap:EffectiveIncomeTaxRateContinuingOperations>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_19">3.49</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="pure" decimals="INF" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_3_0">0.3500</us-gaap:EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate>
  <us-gaap:EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_3_4">0.0048</us-gaap:EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance>
  <us-gaap:EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_3_5">0.0006</us-gaap:EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent>
  <us-gaap:EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_3_1">0.0294</us-gaap:EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes>
  <us-gaap:ExcessTaxBenefitFromShareBasedCompensationFinancingActivities contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_33">4241000</us-gaap:ExcessTaxBenefitFromShareBasedCompensationFinancingActivities>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_18">3.52</us-gaap:EarningsPerShareBasic>
  <us-gaap:EffectiveIncomeTaxRateReconciliationNondeductibleExpense contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_3_2">0.0043</us-gaap:EffectiveIncomeTaxRateReconciliationNondeductibleExpense>
  <us-gaap:EffectiveIncomeTaxRateReconciliationOtherAdjustments contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="pure" decimals="4" id="id_14062202_70AC0C1D-8CA4-4508-8B4B-366EEA0EFD75_3_3">-0.0211</us-gaap:EffectiveIncomeTaxRateReconciliationOtherAdjustments>
  <us-gaap:FederalIncomeTaxExpenseBenefitContinuingOperations contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_3_2">182354000</us-gaap:FederalIncomeTaxExpenseBenefitContinuingOperations>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_4">372572000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_12">513799000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_10">3185000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_13">189203000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_15">-3452000</us-gaap:IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve>
  <us-gaap:IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_10">783000</us-gaap:IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets>
  <us-gaap:IncomeTaxesPaidNet contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_44">175962000</us-gaap:IncomeTaxesPaidNet>
  <us-gaap:IncreaseDecreaseInAccountsPayableAndAccruedLiabilities contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_12">11617000</us-gaap:IncreaseDecreaseInAccountsPayableAndAccruedLiabilities>
  <us-gaap:IncreaseDecreaseInAccruedIncomeTaxesPayable contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_13">-2234000</us-gaap:IncreaseDecreaseInAccruedIncomeTaxesPayable>
  <us-gaap:IncreaseDecreaseInOtherNoncurrentAssets contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_11">-10035000</us-gaap:IncreaseDecreaseInOtherNoncurrentAssets>
  <us-gaap:IncreaseDecreaseInAccountsReceivable contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_9">34000000</us-gaap:IncreaseDecreaseInAccountsReceivable>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_9">63092000</us-gaap:InterestExpense>
  <us-gaap:IncreaseDecreaseInOtherOperatingLiabilities contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_16">-7405000</us-gaap:IncreaseDecreaseInOtherOperatingLiabilities>
  <us-gaap:IncrementalCommonSharesAttributableToShareBasedPaymentArrangements contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="shares" decimals="-3" id="id_14062202_5D948726-9D47-457B-BD6D-63332D0C9B24_3_1">687000</us-gaap:IncrementalCommonSharesAttributableToShareBasedPaymentArrangements>
  <us-gaap:InterestPaidNet contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_43">60453000</us-gaap:InterestPaidNet>
  <us-gaap:InvestmentIncomeNet contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_8">2019000</us-gaap:InvestmentIncomeNet>
  <us-gaap:LeaseAndRentalExpense contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_EE3DBF28-717E-4E17-B56B-93BBC8045234_3_0">38000000</us-gaap:LeaseAndRentalExpense>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredNet contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_3_7">13176000</us-gaap:MalpracticeLossContingencyClaimsIncurredNet>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_11">-57888000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredInPeriod contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_3_5">766000</us-gaap:MalpracticeLossContingencyClaimsIncurredInPeriod>
  <us-gaap:MalpracticeLossContingencyClaimsIncurredInPriorPeriods contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_3_6">12410000</us-gaap:MalpracticeLossContingencyClaimsIncurredInPriorPeriods>
  <us-gaap:NetCashProvidedByUsedInInvestingActivities contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_25">-821217000</us-gaap:NetCashProvidedByUsedInInvestingActivities>
  <us-gaap:NetCashProvidedByUsedInFinancingActivities contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_37">381565000</us-gaap:NetCashProvidedByUsedInFinancingActivities>
  <us-gaap:NetCashProvidedByUsedInOperatingActivities contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_17">443778000</us-gaap:NetCashProvidedByUsedInOperatingActivities>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_16">324914000</us-gaap:NetIncomeLoss>
  <us-gaap:NetIncomeLossAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_15">-318000</us-gaap:NetIncomeLossAttributableToNoncontrollingInterest>
  <us-gaap:OtherNoncashIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_7">-212000</us-gaap:OtherNoncashIncomeExpense>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_6">2611472000</us-gaap:OperatingExpenses>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_7">571687000</us-gaap:OperatingIncomeLoss>
  <us-gaap:PaymentsToAcquireInvestments contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_20">60976000</us-gaap:PaymentsToAcquireInvestments>
  <us-gaap:PaymentsToAcquireOtherPropertyPlantAndEquipment contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_22">39264000</us-gaap:PaymentsToAcquireOtherPropertyPlantAndEquipment>
  <us-gaap:PaymentsForRepurchaseOfCommonStock contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_36">61828000</us-gaap:PaymentsForRepurchaseOfCommonStock>
  <us-gaap:PaymentsToAcquireBusinessesNetOfCashAcquired contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_19">762302000</us-gaap:PaymentsToAcquireBusinessesNetOfCashAcquired>
  <us-gaap:PaymentForContingentConsiderationLiabilityFinancingActivities contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_31">10740000</us-gaap:PaymentForContingentConsiderationLiabilityFinancingActivities>
  <us-gaap:PaymentForContingentConsiderationLiabilityOperatingActivities contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_14">1037000</us-gaap:PaymentForContingentConsiderationLiabilityOperatingActivities>
  <us-gaap:ProceedsFromIssuanceOfCommonStock contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_34">22022000</us-gaap:ProceedsFromIssuanceOfCommonStock>
  <us-gaap:ProceedsFromSaleMaturityAndCollectionsOfInvestments contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_21">41325000</us-gaap:ProceedsFromSaleMaturityAndCollectionsOfInvestments>
  <us-gaap:ProceedsAndExcessTaxBenefitFromSharebasedCompensation contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_6F395465-392B-4EF7-A44E-32EB382B7841_3_1">4700000</us-gaap:ProceedsAndExcessTaxBenefitFromSharebasedCompensation>
  <us-gaap:ProceedsFromLinesOfCredit contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_27">1940000000</us-gaap:ProceedsFromLinesOfCredit>
  <us-gaap:RepaymentsOfLinesOfCredit contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_28">1510000000</us-gaap:RepaymentsOfLinesOfCredit>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_14">324596000</us-gaap:ProfitLoss>
  <us-gaap:RepaymentsOfLongTermCapitalLeaseObligations contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_32">2130000</us-gaap:RepaymentsOfLongTermCapitalLeaseObligations>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_0">3183159000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:ShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_648CD4E3-90D2-44B9-B2FC-F4395D6C8B5B_3_5">34000000</us-gaap:ShareBasedCompensation>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_5080F253-A8E3-4227-B70D-A0CAED6DE09C_3_0">29800000</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_9CB6A509-EAD0-4AB1-AFD9-A8157CACD7B4_3_0">67.90</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue>
  <us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-5" id="id_14062202_0BEDD904-2C88-4DA8-A32F-9B4E71FC7DFB_3_0">6800000</us-gaap:ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue>
  <us-gaap:StateAndLocalIncomeTaxExpenseBenefitContinuingOperations contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_08F1DB3D-1A01-4846-93FD-694581FE0AAD_3_5">6849000</us-gaap:StateAndLocalIncomeTaxExpenseBenefitContinuingOperations>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4006_900011">61828000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4006_900004">22022000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation>
  <us-gaap:UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_3_4">5644000</us-gaap:UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities>
  <us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_3_1">301000</us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions>
  <us-gaap:UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_3_5">1966000</us-gaap:UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="shares" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_22">93109000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="shares" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_21">92422000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_3_3">2258000</us-gaap:UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions>
  <us-gaap:UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_6E9FDE1F-7B22-4EE2-BE1A-EAB5FD0CD7B9_3_2">3927000</us-gaap:UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions>
  <md:ProvisionAdjustmentForLossesRelatedToPriorYear contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_3_3">-25428000</md:ProvisionAdjustmentForLossesRelatedToPriorYear>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_3">118416000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:MalpracticeLossContingencyProvisionForLosses contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_3_4">12701000</md:MalpracticeLossContingencyProvisionForLosses>
  <md:ProvisionAdjustmentForLossesRelatedToCurrentYear contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_3F469D8C-66DA-43E2-8F68-C49C565A7001_3_2">38129000</md:ProvisionAdjustmentForLossesRelatedToCurrentYear>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_F0C02E6D-CF9B-49F8-AF3F-FE4E7CC85D90_3_2">2031220000</md:PracticeSalariesAndBenefits>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_3_4">1.00</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245" unitRef="pure" decimals="INF" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_1003_6">1.00</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3073813" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_2003_4">0.05</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3245705" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_3003_2">0.06</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3253054" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_4003_0">0.39</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3253055" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_5003_1">0.39</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3253056" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_6003_3">0.08</us-gaap:ConcentrationRiskPercentage1>
  <us-gaap:ConcentrationRiskPercentage1 contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3317063" unitRef="pure" decimals="2" id="id_14062202_574AE1A6-A75F-47A0-A4C9-3CE7E8A74DE2_7003_5">0.03</us-gaap:ConcentrationRiskPercentage1>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3071347x3071755" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_1003_1">0.23</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3071347x3080487" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_2003_3">0.01</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3071347x3081046" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_3003_2">0.06</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3071347x3281104" unitRef="pure" decimals="2" id="id_14062202_5336C48A-3641-4402-9631-BC5BB1A83202_4003_0">0.70</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3077210x3071532" unitRef="iso4217_USD" decimals="-3" id="id_14062202_04DF90CB-17A0-49B6-80F6-CCFE1209913A_1003_1">2760192000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3077210x3073813" unitRef="iso4217_USD" decimals="-3" id="id_14062202_04DF90CB-17A0-49B6-80F6-CCFE1209913A_2003_3">151081000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3077210x3296576" unitRef="iso4217_USD" decimals="-3" id="id_14062202_04DF90CB-17A0-49B6-80F6-CCFE1209913A_3003_2">271886000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3078734x3268616" unitRef="iso4217_USD" decimals="-5" id="id_14062202_6C8DDD61-305F-4BD0-A872-046929E36F97_1002_0">7900000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4003_600013">4131000</us-gaap:AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation>
  <us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4003_600008">34000000</us-gaap:AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4003_600006">-5000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4003_600011">12075000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4003_600009">-1000</us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3063589" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4003_600004">22017000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation>
  <us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensationGross contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4001_400007">505000</us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensationGross>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4001_500006">5000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensationGross>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4001_500011">9000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4001_400010">53000</us-gaap:StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited>
  <us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4001_400005">473000</us-gaap:StockIssuedDuringPeriodSharesShareBasedCompensation>
  <us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4001_500009">1000</us-gaap:StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures>
  <us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3065602" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4001_500004">5000</us-gaap:StockIssuedDuringPeriodValueShareBasedCompensation>
  <us-gaap:StockRepurchasedDuringPeriodShares contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3065602" unitRef="shares" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4001_400012">946000</us-gaap:StockRepurchasedDuringPeriodShares>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3076080" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4005_800003">-318000</us-gaap:ProfitLoss>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3078149" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4004_700003">324914000</us-gaap:ProfitLoss>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3078149" unitRef="iso4217_USD" decimals="-3" id="id_14062202_95ABEBA5-15A6-4780-864B-856B63B315D7_4004_700011">49744000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_4">25614000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_15">0.59</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_14">0.59</us-gaap:EarningsPerShareBasic>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_3">103765000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_11">89658000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_9">797000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_12">34967000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_8">17752000</us-gaap:InterestExpense>
  <us-gaap:InvestmentIncomeNet contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_7">576000</us-gaap:InvestmentIncomeNet>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_10">-16379000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_13">54691000</us-gaap:NetIncomeLoss>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_5">729560000</us-gaap:OperatingExpenses>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_6">106037000</us-gaap:OperatingIncomeLoss>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_0">835597000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="shares" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_17">93143000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="shares" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_16">92360000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_2">27796000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-K0015_STD_90_20170331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_1_1">572385000</md:PracticeSalariesAndBenefits>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_4">26163000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_17">0.68</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_16">0.68</us-gaap:EarningsPerShareBasic>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_3">108776000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_11">87487000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_9">1525000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_12">24059000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_8">19935000</us-gaap:InterestExpense>
  <us-gaap:InvestmentIncomeNet contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_7">1464000</us-gaap:InvestmentIncomeNet>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_10">-16946000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_15">63428000</us-gaap:NetIncomeLoss>
  <us-gaap:NetIncomeLossAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_14">0</us-gaap:NetIncomeLossAttributableToNoncontrollingInterest>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_5">797424000</us-gaap:OperatingExpenses>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_6">104433000</us-gaap:OperatingIncomeLoss>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_13">0</us-gaap:ProfitLoss>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_0">901857000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="shares" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_19">93505000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="shares" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_18">92859000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_2">30655000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-K0015_STD_90_20180331_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_1_1">631830000</md:PracticeSalariesAndBenefits>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_4">25735000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_15">0.69</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_14">0.69</us-gaap:EarningsPerShareBasic>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_3">103015000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_11">104423000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_9">689000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_12">40725000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_8">18535000</us-gaap:InterestExpense>
  <us-gaap:InvestmentIncomeNet contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_7">365000</us-gaap:InvestmentIncomeNet>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_10">-17481000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_13">63698000</us-gaap:NetIncomeLoss>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_5">721040000</us-gaap:OperatingExpenses>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_6">121904000</us-gaap:OperatingIncomeLoss>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_0">842944000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="shares" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_17">92812000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="shares" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_16">92181000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_2">30872000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-K0015_STD_91_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_2_1">561418000</md:PracticeSalariesAndBenefits>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_4">26518000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_17">0.85</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_16">0.85</us-gaap:EarningsPerShareBasic>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_3">107908000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_11">109534000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_9">1257000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_12">30122000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_8">21604000</us-gaap:InterestExpense>
  <us-gaap:InvestmentIncomeNet contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_7">1202000</us-gaap:InvestmentIncomeNet>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_10">-19145000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_15">79412000</us-gaap:NetIncomeLoss>
  <us-gaap:NetIncomeLossAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_14">0</us-gaap:NetIncomeLossAttributableToNoncontrollingInterest>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_5">787239000</us-gaap:OperatingExpenses>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_6">128679000</us-gaap:OperatingIncomeLoss>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_13">0</us-gaap:ProfitLoss>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_0">915918000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="shares" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_19">93529000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="shares" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_18">92987000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_2">31833000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_2_1">620980000</md:PracticeSalariesAndBenefits>
  <us-gaap:AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0_3064218x3079518" unitRef="iso4217_USD" decimals="-5" id="id_14062202_936D0C4D-9354-4609-82F5-22BFB36423D7_1002_3">2500000</us-gaap:AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation>
  <us-gaap:SharesPaidForTaxWithholdingForShareBasedCompensation contextRef="eol_PE10840---1810-K0015_STD_91_20180630_0_3064218x3079518" unitRef="shares" decimals="INF" id="id_14062202_936D0C4D-9354-4609-82F5-22BFB36423D7_1002_2">54909</us-gaap:SharesPaidForTaxWithholdingForShareBasedCompensation>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_4">25116000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_15">0.71</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_14">0.71</us-gaap:EarningsPerShareBasic>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_3">101430000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_11">107999000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_9">-240000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_12">42119000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_8">18428000</us-gaap:InterestExpense>
  <us-gaap:InvestmentIncomeNet contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_7">235000</us-gaap:InvestmentIncomeNet>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_10">-18433000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_13">65880000</us-gaap:NetIncomeLoss>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_5">742519000</us-gaap:OperatingExpenses>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_6">126432000</us-gaap:OperatingIncomeLoss>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_0">868951000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="shares" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_17">92881000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="shares" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_16">92589000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_2">29497000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-K0015_STD_92_20170930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_3_1">586476000</md:PracticeSalariesAndBenefits>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_4">28709000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_17">0.72</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_16">0.72</us-gaap:EarningsPerShareBasic>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_3">102905000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_11">90448000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_9">1766000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_12">24873000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_8">21782000</us-gaap:InterestExpense>
  <us-gaap:InvestmentIncomeNet contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_7">1302000</us-gaap:InvestmentIncomeNet>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_10">-18714000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_15">65575000</us-gaap:NetIncomeLoss>
  <us-gaap:NetIncomeLossAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_14">0</us-gaap:NetIncomeLossAttributableToNoncontrollingInterest>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_5">787490000</us-gaap:OperatingExpenses>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_6">109162000</us-gaap:OperatingIncomeLoss>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_13">0</us-gaap:ProfitLoss>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_0">896652000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="shares" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_19">91359000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="shares" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_18">90984000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_2">30159000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-K0015_STD_92_20180930_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_3_1">625717000</md:PracticeSalariesAndBenefits>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_4">26414000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_15">1.46</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_14">1.47</us-gaap:EarningsPerShareBasic>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_3">108895000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_11">108342000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_9">-294000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_12">-27761000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-6" id="id_14062202_825CA47E-8C6C-4752-B30C-4D0591235E93_5_2">-70000000</us-gaap:IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_8">19844000</us-gaap:InterestExpense>
  <us-gaap:InvestmentIncomeNet contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_7">2777000</us-gaap:InvestmentIncomeNet>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_10">-17361000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_13">136103000</us-gaap:NetIncomeLoss>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_5">785117000</us-gaap:OperatingExpenses>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_6">125703000</us-gaap:OperatingIncomeLoss>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_0">910820000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="shares" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_17">93159000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="shares" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_16">92756000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_2">32353000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-K0015_STD_92_20171231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_2B63ABBC-E3F4-425B-B3A9-F11AC1B34440_4_1">617455000</md:PracticeSalariesAndBenefits>
  <us-gaap:DepreciationDepletionAndAmortization contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_4">29891000</us-gaap:DepreciationDepletionAndAmortization>
  <us-gaap:EarningsPerShareDiluted contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_17">0.68</us-gaap:EarningsPerShareDiluted>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_16">0.69</us-gaap:EarningsPerShareBasic>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_3">112789000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_11">81370000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_9">2277000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_12">21156000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:InterestExpense contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_8">25448000</us-gaap:InterestExpense>
  <us-gaap:InvestmentIncomeNet contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_7">967000</us-gaap:InvestmentIncomeNet>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_10">-22204000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:NetIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_15">60214000</us-gaap:NetIncomeLoss>
  <us-gaap:NetIncomeLossAttributableToNoncontrollingInterest contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_14">0</us-gaap:NetIncomeLossAttributableToNoncontrollingInterest>
  <us-gaap:OperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_5">829122000</us-gaap:OperatingExpenses>
  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_6">103574000</us-gaap:OperatingIncomeLoss>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_13">0</us-gaap:ProfitLoss>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_0">932696000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="shares" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_19">88258000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="shares" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_18">87810000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_2">29381000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-K0015_STD_92_20181231_0" unitRef="iso4217_USD" decimals="-3" id="id_14062202_5F746C2E-4D2C-48ED-A99A-F8F250FD3493_4_1">657061000</md:PracticeSalariesAndBenefits>
  <context id="eol_PE10840---1810-K0015_STD_92_20181231_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2018-10-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_92_20171231_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2017-10-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_92_20180930_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2018-07-01</startDate>
      <endDate>2018-09-30</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_92_20170930_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2017-07-01</startDate>
      <endDate>2017-09-30</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_91_20180630_0_3064218x3079518">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:AwardTypeAxis">us-gaap:RestrictedStockMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-04-01</startDate>
      <endDate>2018-06-30</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_91_20180630_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2018-04-01</startDate>
      <endDate>2018-06-30</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_91_20170630_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2017-04-01</startDate>
      <endDate>2017-06-30</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_90_20180331_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-03-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_90_20170331_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-03-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3078149">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:RetainedEarningsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3076080">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:NoncontrollingInterestMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3065602">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:CommonStockMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3080925x3063589">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:AdditionalPaidInCapitalMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3078734x3268616">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis">md:InterestAndPenaltiesMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3077210x3296576">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:HospitalsContractsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3077210x3073813">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">us-gaap:ManagementServiceMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3077210x3071532">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">us-gaap:HealthCarePatientServiceMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3071347x3281104">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">md:ContractedManagedCareMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3071347x3081046">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">us-gaap:ThirdPartyPayorMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3071347x3080487">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">us-gaap:SelfPayMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3071347x3071755">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">us-gaap:GovernmentMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3317063">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:PediatricCardiologyMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3253056">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:MaternalFetalMedicineMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3253055">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:AnesthesiologyMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3253054">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:NeonatologyAndOtherPediatricSubspecialtiesMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3245705">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:RadiologyAndTeleradiologyMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245_3077210x3073813">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">us-gaap:ManagementServiceMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0_3065617x3078903_3065618x3078245">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_366_20161231_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2016-01-01</startDate>
      <endDate>2016-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20191231_0_3081295x3078919">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementScenarioAxis">us-gaap:ScenarioForecastMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2019-01-01</startDate>
      <endDate>2019-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3081022x3068238">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:TaxPeriodAxis">us-gaap:EarliestTaxYearMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3078149">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:RetainedEarningsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3065602">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:CommonStockMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3080925x3063589">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:AdditionalPaidInCapitalMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3078512x3075282">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MinimumMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3078512x3074821">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MaximumMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3081128_3078512x3075282">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MinimumMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:PropertyPlantAndEquipmentByTypeAxis">us-gaap:SoftwareAndSoftwareDevelopmentCostsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3081128_3078512x3074821">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MaximumMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:PropertyPlantAndEquipmentByTypeAxis">us-gaap:SoftwareAndSoftwareDevelopmentCostsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3070568_3078512x3075282">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MinimumMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:PropertyPlantAndEquipmentByTypeAxis">us-gaap:FurnitureAndFixturesMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3070568_3078512x3074821">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MaximumMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:PropertyPlantAndEquipmentByTypeAxis">us-gaap:FurnitureAndFixturesMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3068864_3078512x3075282">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MinimumMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:PropertyPlantAndEquipmentByTypeAxis">us-gaap:EquipmentMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3068864_3078512x3074821">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MaximumMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:PropertyPlantAndEquipmentByTypeAxis">us-gaap:EquipmentMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3065616_3078512x3075282">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MinimumMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:PropertyPlantAndEquipmentByTypeAxis">us-gaap:ComputerEquipmentMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3065616_3078512x3074821">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MaximumMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:PropertyPlantAndEquipmentByTypeAxis">us-gaap:ComputerEquipmentMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3078429x3064276">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:PropertyPlantAndEquipmentByTypeAxis">us-gaap:BuildingMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3077210x3296576">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:HospitalsContractsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3077210x3073813">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">us-gaap:ManagementServiceMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3077210x3071532">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">us-gaap:HealthCarePatientServiceMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3076363x3384934">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:PlanNameAxis">md:NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3076363x3271447">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:PlanNameAxis">md:NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3076363x3266135">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:PlanNameAxis">md:TwoThousandFifteenNonQualifiedStockPurchasePlanMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3071347x3281104">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">md:ContractedManagedCareMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3071347x3081046">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">us-gaap:ThirdPartyPayorMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3071347x3080487">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">us-gaap:SelfPayMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3071347x3071755">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">us-gaap:GovernmentMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3070943x3294255">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:FiniteLivedIntangibleAssetsByMajorClassAxis">md:PhysicianAndHospitalAgreementsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066061x3334909_3078512x3075282_3082302x3074465">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MinimumMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentAxis">md:ApplicableMarginRateMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:VariableRateAxis">us-gaap:LondonInterbankOfferedRateLIBORMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066061x3334909_3078512x3074821_3082302x3074465">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MaximumMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentAxis">md:ApplicableMarginRateMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:VariableRateAxis">us-gaap:LondonInterbankOfferedRateLIBORMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066061x3320305_3082302x3074465">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentAxis">md:AlternateBaseRateMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:VariableRateAxis">us-gaap:LondonInterbankOfferedRateLIBORMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066061x3320305_3082302x3069706">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentAxis">md:AlternateBaseRateMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:VariableRateAxis">us-gaap:FederalFundsEffectiveSwapRateMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3076720x3252743">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:OtherOwnershipInterestsByNameAxis">md:ChangeInControlMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3538549_3081295x3332561">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentRedemptionPeriodAxis">md:DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:StatementScenarioAxis">md:RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3538549">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentRedemptionPeriodAxis">md:DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3255258">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentRedemptionPeriodAxis">md:DebtInstrumentRedemptionPeriodSixAndThereafterMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3066720">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentRedemptionPeriodAxis">us-gaap:DebtInstrumentRedemptionPeriodFiveMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3066314">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentRedemptionPeriodAxis">us-gaap:DebtInstrumentRedemptionPeriodFourMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202_3066719x3066088">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentRedemptionPeriodAxis">us-gaap:DebtInstrumentRedemptionPeriodThreeMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3538202">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3297729_3076720x3252743">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:OtherOwnershipInterestsByNameAxis">md:ChangeInControlMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3297729_3066719x3279121">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentRedemptionPeriodAxis">md:DebtInstrumentRedemptionPeriodThreeAndThereafterMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3297729_3066719x3066721">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentRedemptionPeriodAxis">us-gaap:DebtInstrumentRedemptionPeriodOneMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3297729_3066719x3066089">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:DebtInstrumentRedemptionPeriodAxis">us-gaap:DebtInstrumentRedemptionPeriodTwoMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3066013x3297729">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3317063">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:PediatricCardiologyMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3253056">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:MaternalFetalMedicineMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3253055">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:AnesthesiologyMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3253054">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:NeonatologyAndOtherPediatricSubspecialtiesMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3245705">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:RadiologyAndTeleradiologyMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245_3077210x3073813">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">us-gaap:ManagementServiceMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3078903_3065618x3078245">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3065617x3063975_3065618x3071754">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:AccountsReceivableMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:GovernmentContractsConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3064719x3321594">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:BusinessAcquisitionAxis">md:PhysicianGroupMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3064719x3302268">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:BusinessAcquisitionAxis">md:PriorPeriodAcquisitionsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3064218x3291163">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:AwardTypeAxis">md:RestrictedAndDeferredStockUnitsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3064218x3079518">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:AwardTypeAxis">us-gaap:RestrictedStockMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3064218x3069261_3078512x3074821">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:RangeAxis">srt:MaximumMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:AwardTypeAxis">us-gaap:EmployeeStockOptionMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0_3064218x3069261">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:AwardTypeAxis">us-gaap:EmployeeStockOptionMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20181231_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2018-01-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3081022x3073129">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:TaxPeriodAxis">us-gaap:LatestTaxYearMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3078149">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:RetainedEarningsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3065602">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:CommonStockMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3080925x3063589">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:AdditionalPaidInCapitalMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3078734x3268616">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis">md:InterestAndPenaltiesMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3077210x3296576">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:HospitalsContractsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3077210x3073813">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">us-gaap:ManagementServiceMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3077210x3071532">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">us-gaap:HealthCarePatientServiceMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3071347x3281104">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">md:ContractedManagedCareMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3071347x3081046">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">us-gaap:ThirdPartyPayorMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3071347x3080487">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">us-gaap:SelfPayMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3071347x3071755">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:HealthCareOrganizationRevenueSourcesAxis">us-gaap:GovernmentMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3317063">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:PediatricCardiologyMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3253056">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:MaternalFetalMedicineMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3253055">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:AnesthesiologyMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3253054">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:NeonatologyAndOtherPediatricSubspecialtiesMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3245705">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">md:RadiologyAndTeleradiologyMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245_3077210x3073813">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ProductOrServiceAxis">us-gaap:ManagementServiceMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3078903_3065618x3078245">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:SalesRevenueServicesNetMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:ProductConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3065617x3063975_3065618x3071754">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByBenchmarkAxis">us-gaap:AccountsReceivableMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:ConcentrationRiskByTypeAxis">us-gaap:GovernmentContractsConcentrationRiskMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0_3064218x3079518">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:AwardTypeAxis">us-gaap:RestrictedStockMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_365_20171231_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2017-01-01</startDate>
      <endDate>2017-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_31_20181231_0_3081082x3275817">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:ShareRepurchaseProgramAxis">md:AcceleratedShareRepurchaseAgreementsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-12-01</startDate>
      <endDate>2018-12-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_1_20180904_0_3081082x3275817">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:ShareRepurchaseProgramAxis">md:AcceleratedShareRepurchaseAgreementsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <startDate>2018-09-04</startDate>
      <endDate>2018-09-04</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_1_20170331_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <startDate>2017-03-31</startDate>
      <endDate>2017-03-31</endDate>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3081292x3281103">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementBusinessSegmentsAxis">md:ManagementServicesReportingUnitMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3080925x3078149">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:RetainedEarningsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3080925x3065602">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:CommonStockMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3080925x3063589">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:AdditionalPaidInCapitalMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3079978x3295964">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis">md:UnnamedCorporateJointVentureMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3078429x3252751">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:PropertyPlantAndEquipmentByTypeAxis">md:MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3076363x3384934">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:PlanNameAxis">md:NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3073527x3081530">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:InvestmentTypeAxis">us-gaap:USStatesAndPoliticalSubdivisionsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3073527x3081528">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:InvestmentTypeAxis">us-gaap:USGovernmentSponsoredEnterprisesDebtSecuritiesMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3073527x3065535">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:InvestmentTypeAxis">us-gaap:CertificatesOfDepositMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3294255">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:FiniteLivedIntangibleAssetsByMajorClassAxis">md:PhysicianAndHospitalAgreementsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3253046">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:FiniteLivedIntangibleAssetsByMajorClassAxis">md:PatentedAndOtherTechnologyMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3081468">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:FiniteLivedIntangibleAssetsByMajorClassAxis">us-gaap:TradeNamesMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3070943x3066421">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:FiniteLivedIntangibleAssetsByMajorClassAxis">us-gaap:CustomerRelationshipsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3538202_3068684x3070091_3070058x3068644">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:FairValueByFairValueHierarchyLevelAxis">us-gaap:FairValueInputsLevel2Member</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:FairValueByMeasurementBasisAxis">us-gaap:EstimateOfFairValueFairValueDisclosureMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3538202">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3336802">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:UnsecuredRevolvingCreditFacilityMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3297729_3068684x3070091_3070058x3068644">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:FairValueByFairValueHierarchyLevelAxis">us-gaap:FairValueInputsLevel2Member</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:FairValueByMeasurementBasisAxis">us-gaap:EstimateOfFairValueFairValueDisclosureMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3297729">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3078864">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">us-gaap:RevolvingCreditFacilityMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3066013x3073193">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">us-gaap:LetterOfCreditMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3065136x3541682">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:ChangeInAccountingEstimateByTypeAxis">md:InternalRevenueCodeSection481Member</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3064719x3321594">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:BusinessAcquisitionAxis">md:PhysicianGroupMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3064719x3302268">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:BusinessAcquisitionAxis">md:PriorPeriodAcquisitionsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3064218x3291163">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:AwardTypeAxis">md:RestrictedAndDeferredStockUnitsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0_3064218x3069261_3076363x3258165">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:AwardTypeAxis">us-gaap:EmployeeStockOptionMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:PlanNameAxis">md:AmendedAndRestatedTwoThousandEightPlanMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181231_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <instant>2018-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3080925x3078149">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:RetainedEarningsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3080925x3065602">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:CommonStockMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3080925x3063589">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:AdditionalPaidInCapitalMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3078429x3252751">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:PropertyPlantAndEquipmentByTypeAxis">md:MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3073527x3081530">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:InvestmentTypeAxis">us-gaap:USStatesAndPoliticalSubdivisionsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3073527x3081528">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:InvestmentTypeAxis">us-gaap:USGovernmentSponsoredEnterprisesDebtSecuritiesMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3073527x3065535">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:InvestmentTypeAxis">us-gaap:CertificatesOfDepositMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3294255">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:FiniteLivedIntangibleAssetsByMajorClassAxis">md:PhysicianAndHospitalAgreementsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3253046">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:FiniteLivedIntangibleAssetsByMajorClassAxis">md:PatentedAndOtherTechnologyMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3081468">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:FiniteLivedIntangibleAssetsByMajorClassAxis">us-gaap:TradeNamesMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3070943x3066421">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:FiniteLivedIntangibleAssetsByMajorClassAxis">us-gaap:CustomerRelationshipsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3066013x3297729_3068684x3070091_3070058x3068644">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:FairValueByFairValueHierarchyLevelAxis">us-gaap:FairValueInputsLevel2Member</xbrldi:explicitMember><xbrldi:explicitMember dimension="us-gaap:FairValueByMeasurementBasisAxis">us-gaap:EstimateOfFairValueFairValueDisclosureMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3066013x3297729">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0_3066013x3078864">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">us-gaap:RevolvingCreditFacilityMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20171231_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <instant>2017-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20161231_0_3080925x3078149">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:RetainedEarningsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2016-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20161231_0_3080925x3065602">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:CommonStockMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2016-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20161231_0_3080925x3063589">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:AdditionalPaidInCapitalMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2016-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20161231_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <instant>2016-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20151231_0_3080925x3078149">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:RetainedEarningsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2015-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20151231_0_3080925x3076080">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:NoncontrollingInterestMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2015-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20151231_0_3080925x3065602">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:CommonStockMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2015-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20151231_0_3080925x3063589">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:StatementEquityComponentsAxis">us-gaap:AdditionalPaidInCapitalMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2015-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20151231_0_3066013x3297729">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2015-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20151231_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <instant>2015-12-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20180831_0_3081082x3275817">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:ShareRepurchaseProgramAxis">md:AcceleratedShareRepurchaseAgreementsMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-08-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20180831_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <instant>2018-08-31</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20180630_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <instant>2018-06-30</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20160930_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <instant>2016-09-30</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20190207_0">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
    </entity>
    <period>
      <instant>2019-02-07</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20181130_0_3066013x3538202">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="us-gaap:CreditFacilityAxis">md:SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-11-30</instant>
    </period>
  </context>
  <context id="eol_PE10840---1810-K0015_STD_0_20180131_0_3079978x3295964">
    <entity>
      <identifier scheme="http://www.sec.gov/CIK">0000893949</identifier>
      <segment><xbrldi:explicitMember dimension="srt:ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis">md:UnnamedCorporateJointVentureMember</xbrldi:explicitMember></segment>
    </entity>
    <period>
      <instant>2018-01-31</instant>
    </period>
  </context>
  <unit id="pure">
    <measure>pure</measure>
  </unit>
  <unit id="iso4217_USD">
    <measure>iso4217:USD</measure>
  </unit>
  <unit id="shares">
    <measure>shares</measure>
  </unit>
  <unit id="iso4217_USD_per_shares">
    <divide>
      <unitNumerator>
        <measure>iso4217:USD</measure>
      </unitNumerator>
      <unitDenominator>
        <measure>shares</measure>
      </unitDenominator>
    </divide>
  </unit>
  <unit id="Company">
    <measure>md:Company</measure>
  </unit>
</xbrl>

</XBRL>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.SCH
<SEQUENCE>12
<FILENAME>md-20181231.xsd
<DESCRIPTION>XBRL TAXONOMY EXTENSION SCHEMA
<TEXT>
<XBRL>
<?xml version="1.0" encoding="US-ASCII"?>
<!-- DFS Xcelerate Taxonomy Schema - http://www.dfsco.com/financial-services/ -->
<!-- Version: 6.23.6 -->
<!-- Round: 4 -->
<!-- Creation date: 2019-02-13T01:59:33Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
<schema xmlns="http://www.w3.org/2001/XMLSchema"
  xmlns:xbrli="http://www.xbrl.org/2003/instance"
  xmlns:link="http://www.xbrl.org/2003/linkbase"
  xmlns:xlink="http://www.w3.org/1999/xlink"
  xmlns:srt-types="http://fasb.org/srt-types/2018-01-31"
  xmlns:srt="http://fasb.org/srt/2018-01-31"
  xmlns:us-gaap="http://fasb.org/us-gaap/2018-01-31"
  xmlns:us-types="http://fasb.org/us-types/2018-01-31"
  xmlns:md="http://www.mednax.com/20181231"
  xmlns:nonnum="http://www.xbrl.org/dtr/type/non-numeric"
  xmlns:num="http://www.xbrl.org/dtr/type/numeric"
  xmlns:xbrldt="http://xbrl.org/2005/xbrldt"
  xmlns:country="http://xbrl.sec.gov/country/2017-01-31"
  xmlns:currency="http://xbrl.sec.gov/currency/2017-01-31"
  xmlns:dei="http://xbrl.sec.gov/dei/2018-01-31"
  xmlns:exch="http://xbrl.sec.gov/exch/2018-01-31"
  xmlns:invest="http://xbrl.sec.gov/invest/2013-01-31"
  xmlns:naics="http://xbrl.sec.gov/naics/2017-01-31"
  xmlns:sic="http://xbrl.sec.gov/sic/2011-01-31"
  xmlns:stpr="http://xbrl.sec.gov/stpr/2018-01-31"
  targetNamespace="http://www.mednax.com/20181231"
  elementFormDefault="qualified" attributeFormDefault="unqualified">
  <annotation>
    <appinfo>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DocumentandEntityInformation" id="DocumentandEntityInformation">
        <link:definition>101 - Document - Document and Entity Information</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassified" id="StatementOfFinancialPositionClassified">
        <link:definition>103 - Statement - Consolidated Balance Sheets</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassifiedParenthetical" id="StatementOfFinancialPositionClassifiedParen">
        <link:definition>104 - Statement - Consolidated Balance Sheets (Parenthetical)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/StatementOfIncomeAlternative" id="StatementOfIncomeAlternative">
        <link:definition>105 - Statement - Consolidated Statements of Income</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/StatementOfShareholdersEquityAndOtherComprehensiveIncome" id="StatementOfShareholdersEquityAndOtherComprehensiveIncome">
        <link:definition>106 - Statement - Consolidated Statements of Equity</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/StatementOfCashFlowsIndirect" id="StatementOfCashFlowsIndirect">
        <link:definition>107 - Statement - Consolidated Statements of Cash Flows</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsNatureOfOperations" id="Role_NotesToFinancialStatementsNatureOfOperations">
        <link:definition>108 - Disclosure - General</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock" id="Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock">
        <link:definition>109 - Disclosure - Summary of Significant Accounting Policies</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" id="Role_NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock">
        <link:definition>110 - Disclosure - Investments</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock" id="Role_NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock">
        <link:definition>111 - Disclosure - Accounts Receivable and Net Revenue</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock" id="Role_NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock">
        <link:definition>112 - Disclosure - Property and Equipment</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock" id="Role_NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock">
        <link:definition>113 - Disclosure - Business Acquisitions</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock" id="Role_NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock">
        <link:definition>114 - Disclosure - Goodwill and Intangible Assets</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" id="Role_NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock">
        <link:definition>115 - Disclosure - Accounts Payable and Accrued Expenses</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock" id="Role_NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock">
        <link:definition>116 - Disclosure - Accrued Professional Liabilities</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock" id="Role_NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock">
        <link:definition>117 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlock" id="Role_NotesToFinancialStatementsIncomeTaxDisclosureTextBlock">
        <link:definition>118 - Disclosure - Income Taxes</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlock" id="Role_NotesToFinancialStatementsEarningsPerShareTextBlock">
        <link:definition>119 - Disclosure - Common and Common Equivalent Shares</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" id="Role_NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock">
        <link:definition>120 - Disclosure - Stock Incentive Plans and Stock Purchase Plans</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommonStockRepurchasesTextBlock" id="Role_NotesToFinancialStatementsCommonStockRepurchasesTextBlock">
        <link:definition>121 - Disclosure - Common Stock Repurchase Programs</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock" id="Role_NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock">
        <link:definition>122 - Disclosure - Retirement Plans</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock" id="Role_NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock">
        <link:definition>123 - Disclosure - Commitments and Contingencies</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock" id="Role_NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock">
        <link:definition>124 - Disclosure - Selected Quarterly Financial Information</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies" id="Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies">
        <link:definition>125 - Disclosure - Summary of Significant Accounting Policies (Policies)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables" id="Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables">
        <link:definition>126 - Disclosure - Summary of Significant Accounting Policies (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables" id="Role_NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables">
        <link:definition>127 - Disclosure - Investments (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables" id="Role_NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables">
        <link:definition>128 - Disclosure - Accounts Receivable and Net Revenue (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables" id="Role_NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables">
        <link:definition>129 - Disclosure - Property and Equipment (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables" id="Role_NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables">
        <link:definition>130 - Disclosure - Goodwill and Intangible Assets (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables" id="Role_NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables">
        <link:definition>131 - Disclosure - Accounts Payable and Accrued Expenses (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables" id="Role_NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables">
        <link:definition>132 - Disclosure - Accrued Professional Liabilities (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables" id="Role_NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables">
        <link:definition>133 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables" id="Role_NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables">
        <link:definition>134 - Disclosure - Income Taxes (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlockTables" id="Role_NotesToFinancialStatementsEarningsPerShareTextBlockTables">
        <link:definition>135 - Disclosure - Common and Common Equivalent Shares (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables" id="Role_NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables">
        <link:definition>136 - Disclosure - Stock Incentive Plans and Stock Purchase Plans (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables" id="Role_NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables">
        <link:definition>137 - Disclosure - Commitments and Contingencies (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables" id="Role_NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables">
        <link:definition>138 - Disclosure - Selected Quarterly Financial Information (Tables)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation" id="DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation">
        <link:definition>139 - Disclosure - Summary of Significant Accounting Policies - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine" id="DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine">
        <link:definition>140 - Disclosure - Summary of Significant Accounting Policies - Schedule of Net Revenue by Service Line (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfInvestments" id="DisclosureInvestmentsScheduleOfInvestments">
        <link:definition>141 - Disclosure - Investments - Schedule of Investments (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments" id="DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments">
        <link:definition>142 - Disclosure - Investments - Schedule of Contractual Maturities of Long-Term Investments (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet" id="DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet">
        <link:definition>143 - Disclosure - Accounts Receivable and Net Revenue - Schedule of Accounts Receivable, Net (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue" id="DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue">
        <link:definition>144 - Disclosure - Accounts Receivable and Net Revenue - Schedule of Net Revenue (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor" id="DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor">
        <link:definition>145 - Disclosure - Accounts Receivable and Net Revenue - Schedule of Net Patient Service Revenue by Type of Payor (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueAdditionalInformation" id="DisclosureAccountsReceivableAndNetRevenueAdditionalInformation">
        <link:definition>146 - Disclosure - Accounts Receivable and Net Revenue - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment" id="DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment">
        <link:definition>147 - Disclosure - Property Plant and Equipment - Schedule of Property and Equipment (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosurePropertyAndEquipmentAdditionalInformation" id="DisclosurePropertyAndEquipmentAdditionalInformation">
        <link:definition>148 - Disclosure - Property and Equipment - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureBusinessAcquisitionsAdditionalInformation" id="DisclosureBusinessAcquisitionsAdditionalInformation">
        <link:definition>149 - Disclosure - Business Acquisitions - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAdditionalInformation" id="DisclosureGoodwillAndIntangibleAssetsAdditionalInformation">
        <link:definition>150 - Disclosure - Goodwill and Intangible Assets - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet" id="DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet">
        <link:definition>151 - Disclosure - Goodwill and Intangible Assets - Summary of Intangible Assets, Net (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears" id="DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears">
        <link:definition>152 - Disclosure - Goodwill and Intangible Assets - Amortization Expenses for Existing Intangible Assets for the Next Five Years (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses" id="DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses">
        <link:definition>153 - Disclosure - Accounts Payable and Accrued Expenses - Schedule of Accounts Payable and Accrued Expenses (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesAdditionalInformation" id="DisclosureAccruedProfessionalLiabilitiesAdditionalInformation">
        <link:definition>154 - Disclosure - Accrued Professional Liabilities - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability" id="DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability">
        <link:definition>155 - Disclosure - Accrued Professional Liabilities - Schedule of Accrued Professional Liability (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation" id="DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation">
        <link:definition>156 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt" id="DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt">
        <link:definition>157 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Long-Term Debt (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes" id="DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes">
        <link:definition>158 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations - Summary of Estimated Fair Value of Notes (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations" id="DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations">
        <link:definition>159 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Capital Lease Obligations (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations" id="DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations">
        <link:definition>160 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Amounts Due Under Terms of Capital Lease Obligations (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision" id="DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision">
        <link:definition>161 - Disclosure - Income Taxes - Summary of Components of Income Tax Provision (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesAdditionalInformation" id="DisclosureIncomeTaxesAdditionalInformation">
        <link:definition>162 - Disclosure - Income Taxes - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate" id="DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate">
        <link:definition>163 - Disclosure - Income Taxes - Schedule of Differences Between Effective Rate and United States Federal Income Tax Statutory Rate (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities" id="DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities">
        <link:definition>164 - Disclosure - Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits" id="DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits">
        <link:definition>165 - Disclosure - Income Taxes - Schedule of Activity Related to Gross Unrecognized Tax Benefits (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare" id="DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare">
        <link:definition>166 - Disclosure - Common and Common Equivalent Shares - Schedule of Calculation of Shares Used in Basic and Diluted Net Income Per Share (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation" id="DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation">
        <link:definition>167 - Disclosure - Stock Incentive Plans and Stock Purchase Plans - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards" id="DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards">
        <link:definition>168 - Disclosure - Stock Incentive Plans and Stock Purchase Plans - Schedule of Restricted Stock and Deferred Stock Awards (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards" id="DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards">
        <link:definition>169 - Disclosure - Stock Incentive Plans and Stock Purchase Plans - Schedule of Activity and Certain Other Information Related to Stock Option Awards (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommonStockRepurchaseProgramsAdditionalInformation" id="DisclosureCommonStockRepurchaseProgramsAdditionalInformation">
        <link:definition>170 - Disclosure - Common Stock Repurchase Programs - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureRetirementPlansAdditionalInformation" id="DisclosureRetirementPlansAdditionalInformation">
        <link:definition>171 - Disclosure - Retirement Plans - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesAdditionalInformation" id="DisclosureCommitmentsAndContingenciesAdditionalInformation">
        <link:definition>172 - Disclosure - Commitments and Contingencies - Additional Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases" id="DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases">
        <link:definition>173 - Disclosure - Commitments and Contingencies - Schedule of Future Minimum Lease Payments under Non-Cancelable Operating Leases (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:roleType roleURI="http://www.mednax.com/taxonomy/role/DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation" id="DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation">
        <link:definition>174 - Disclosure - Selected Quarterly Financial Information - Summary of Company's Selected Quarterly Financial Information (Detail)</link:definition>
        <link:usedOn>link:calculationLink</link:usedOn>
        <link:usedOn>link:presentationLink</link:usedOn>
        <link:usedOn>link:definitionLink</link:usedOn>
      </link:roleType>
      <link:linkbaseRef xlink:type="simple" xlink:arcrole="http://www.w3.org/1999/xlink/properties/linkbase" xlink:role="http://www.xbrl.org/2003/role/calculationLinkbaseRef" xlink:href="md-20181231_cal.xml" xlink:title="Calculation Links, all"/>
      <link:linkbaseRef xlink:type="simple" xlink:arcrole="http://www.w3.org/1999/xlink/properties/linkbase" xlink:role="http://www.xbrl.org/2003/role/definitionLinkbaseRef" xlink:href="md-20181231_def.xml" xlink:title="Definition Links, all"/>
      <link:linkbaseRef xlink:type="simple" xlink:arcrole="http://www.w3.org/1999/xlink/properties/linkbase" xlink:role="http://www.xbrl.org/2003/role/labelLinkbaseRef" xlink:href="md-20181231_lab.xml" xlink:title="Label Links, all"/>
      <link:linkbaseRef xlink:type="simple" xlink:arcrole="http://www.w3.org/1999/xlink/properties/linkbase" xlink:role="http://www.xbrl.org/2003/role/presentationLinkbaseRef" xlink:href="md-20181231_pre.xml" xlink:title="Presentation Links, all"/>
    </appinfo>
  </annotation>
  <import namespace="http://www.xbrl.org/2003/instance" schemaLocation="http://www.xbrl.org/2003/xbrl-instance-2003-12-31.xsd"/>
  <import namespace="http://www.xbrl.org/2003/linkbase" schemaLocation="http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd"/>
  <import namespace="http://fasb.org/srt-types/2018-01-31" schemaLocation="http://xbrl.fasb.org/srt/2018/elts/srt-types-2018-01-31.xsd"/>
  <import namespace="http://fasb.org/us-types/2018-01-31" schemaLocation="http://xbrl.fasb.org/us-gaap/2018/elts/us-types-2018-01-31.xsd"/>
  <import namespace="http://www.xbrl.org/dtr/type/non-numeric" schemaLocation="http://www.xbrl.org/dtr/type/nonNumeric-2009-12-16.xsd"/>
  <import namespace="http://www.xbrl.org/dtr/type/numeric" schemaLocation="http://www.xbrl.org/dtr/type/numeric-2009-12-16.xsd"/>
  <import namespace="http://xbrl.org/2005/xbrldt" schemaLocation="http://www.xbrl.org/2005/xbrldt-2005.xsd"/>
  <import namespace="http://fasb.org/srt/2018-01-31" schemaLocation="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd"/>
  <import namespace="http://fasb.org/us-gaap/2018-01-31" schemaLocation="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/country/2017-01-31" schemaLocation="http://xbrl.sec.gov/country/2017/country-2017-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/currency/2017-01-31" schemaLocation="https://xbrl.sec.gov/currency/2017/currency-2017-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/dei/2018-01-31" schemaLocation="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/exch/2018-01-31" schemaLocation="https://xbrl.sec.gov/exch/2018/exch-2018-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/invest/2013-01-31" schemaLocation="https://xbrl.sec.gov/invest/2013/invest-2013-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/naics/2017-01-31" schemaLocation="https://xbrl.sec.gov/naics/2017/naics-2017-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/sic/2011-01-31" schemaLocation="https://xbrl.sec.gov/sic/2011/sic-2011-01-31.xsd"/>
  <import namespace="http://xbrl.sec.gov/stpr/2018-01-31" schemaLocation="https://xbrl.sec.gov/stpr/2018/stpr-2018-01-31.xsd"/>
  <element name="AcceleratedShareRepurchaseAgreementsMember" id="md_AcceleratedShareRepurchaseAgreementsMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" id="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AccountsReceivableAndNetRevenueDisclosureTextBlock" id="md_AccountsReceivableAndNetRevenueDisclosureTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AccruedContingentConsiderationLiabilityCurrent" id="md_AccruedContingentConsiderationLiabilityCurrent" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AccruedPayrollTaxesAndBenefitsCurrent" id="md_AccruedPayrollTaxesAndBenefitsCurrent" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AccruedProfessionalLiabilitiesAssumedThroughAcquisition" id="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AccruedProfessionalLiability" id="md_AccruedProfessionalLiability" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AlternateBaseRateMember" id="md_AlternateBaseRateMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AmendedAndRestatedTwoThousandEightPlanMember" id="md_AmendedAndRestatedTwoThousandEightPlanMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="AnesthesiologyMember" id="md_AnesthesiologyMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ApplicableMarginRateMember" id="md_ApplicableMarginRateMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="BusinessCombinationContingentConsiderationArrangementsTimePeriod" id="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod" type="xbrli:durationItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="CashAndCashEquivalentsMaturityDescription" id="md_CashAndCashEquivalentsMaturityDescription" type="xbrli:stringItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ChangeInControlMember" id="md_ChangeInControlMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="CommonStockLineItems" id="md_CommonStockLineItems" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="CommonStockRepurchasesTextBlock" id="md_CommonStockRepurchasesTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="CommonStockShareRepurchasesPolicyTextBlock" id="md_CommonStockShareRepurchasesPolicyTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="CommonStockTable" id="md_CommonStockTable" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrldt:hypercubeItem"/>
  <element name="ContractedManagedCareMember" id="md_ContractedManagedCareMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DebtInstrumentFairValueLineItems" id="md_DebtInstrumentFairValueLineItems" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DebtInstrumentFairValueTable" id="md_DebtInstrumentFairValueTable" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrldt:hypercubeItem"/>
  <element name="DebtInstrumentMaturityYear" id="md_DebtInstrumentMaturityYear" type="xbrli:gYearItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember" id="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DebtInstrumentRedemptionPeriodSixAndThereafterMember" id="md_DebtInstrumentRedemptionPeriodSixAndThereafterMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DebtInstrumentRedemptionPeriodThreeAndThereafterMember" id="md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DeconsolidationPercentage" id="md_DeconsolidationPercentage" type="num:percentItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DeferredTaxLiabilitiesChangeInAccountingMethod" id="md_DeferredTaxLiabilitiesChangeInAccountingMethod" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="DocumentAndEntityInformationAbstract" id="md_DocumentAndEntityInformationAbstract" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" id="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="GoodwillAndOtherIntangibleAssetsLineItems" id="md_GoodwillAndOtherIntangibleAssetsLineItems" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="HospitalsContractsMember" id="md_HospitalsContractsMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="IncomeTaxExpenseForExcessTaxDeficiencies" id="md_IncomeTaxExpenseForExcessTaxDeficiencies" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="IncomeTaxLineItems" id="md_IncomeTaxLineItems" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="IncomeTaxTable" id="md_IncomeTaxTable" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrldt:hypercubeItem"/>
  <element name="IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" id="md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" id="md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="InterestAndPenaltiesMember" id="md_InterestAndPenaltiesMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="InternalRevenueCodeSection481Member" id="md_InternalRevenueCodeSection481Member" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" id="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="LongTermInvestmentsMaturityPeriod" id="md_LongTermInvestmentsMaturityPeriod" type="xbrli:durationItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="MalpracticeLossContingencyProvisionForLosses" id="md_MalpracticeLossContingencyProvisionForLosses" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ManagementServicesReportingUnitMember" id="md_ManagementServicesReportingUnitMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="MaternalFetalMedicineMember" id="md_MaternalFetalMedicineMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" id="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="MoneyMarketFundsAtFairValue" id="md_MoneyMarketFundsAtFairValue" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NeonatologyAndOtherPediatricSubspecialtiesMember" id="md_NeonatologyAndOtherPediatricSubspecialtiesMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NetOperatingLossCarryForwardsExpirationDate" id="md_NetOperatingLossCarryForwardsExpirationDate" type="xbrli:gYearItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember" id="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember" id="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfMaternalfetalMedicinePracticesAcquired" id="md_NumberOfMaternalfetalMedicinePracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfNeonatologyPracticesAcquired" id="md_NumberOfNeonatologyPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfPediatricMultiSpecialtyPracticesAcquired" id="md_NumberOfPediatricMultiSpecialtyPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfPediatricSubspecialtyPracticesAcquired" id="md_NumberOfPediatricSubspecialtyPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfPhysicianGroupPracticesAcquired" id="md_NumberOfPhysicianGroupPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="NumberOfRadiologyPracticesAcquired" id="md_NumberOfRadiologyPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PatentedAndOtherTechnologyMember" id="md_PatentedAndOtherTechnologyMember" type="nonnum:domainItemType" abstract="true" 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="PediatricCardiologyMember" id="md_PediatricCardiologyMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" 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="PhysicianAndHospitalAgreementsMember" id="md_PhysicianAndHospitalAgreementsMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PhysicianGroupMember" id="md_PhysicianGroupMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PracticeSalariesAndBenefits" id="md_PracticeSalariesAndBenefits" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PracticeSuppliesAndOtherOperatingExpenses" id="md_PracticeSuppliesAndOtherOperatingExpenses" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PriorPeriodAcquisitionsMember" id="md_PriorPeriodAcquisitionsMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ProfessionalLiabilityCoveragePolicyTextBlock" id="md_ProfessionalLiabilityCoveragePolicyTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract" id="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ProvisionAdjustmentForLossesRelatedToCurrentYear" id="md_ProvisionAdjustmentForLossesRelatedToCurrentYear" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ProvisionAdjustmentForLossesRelatedToPriorYear" id="md_ProvisionAdjustmentForLossesRelatedToPriorYear" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="debit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="RadiologyAndTeleradiologyMember" id="md_RadiologyAndTeleradiologyMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="RecentlyAdoptedAccountingPronouncementsPolicyTextBlock" id="md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" id="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="RegulatoryAssetsAbstract" id="md_RegulatoryAssetsAbstract" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="RestrictedAndDeferredStockUnitsMember" id="md_RestrictedAndDeferredStockUnitsMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="SaleOfMinorityInterestPercentage" id="md_SaleOfMinorityInterestPercentage" type="num:percentItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ScheduleOfAccruedProfessionalLiabilityTableTextBlock" id="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ScheduleOfCapitalLeaseObligationsTableTextBlock" id="md_ScheduleOfCapitalLeaseObligationsTableTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="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="SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" id="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration" id="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration" type="xbrli:sharesItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="StockIssuedDuringPeriodSharesStockSwaps" id="md_StockIssuedDuringPeriodSharesStockSwaps" type="xbrli:sharesItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration" id="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="StockIssuedDuringPeriodValueStockSwaps" id="md_StockIssuedDuringPeriodValueStockSwaps" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="SummaryOfEstimatedFairValueOfNotesTableTextBlock" id="md_SummaryOfEstimatedFairValueOfNotesTableTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="SummaryOfSignificantAccountingPoliciesLineItems" id="md_SummaryOfSignificantAccountingPoliciesLineItems" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="SummaryOfSignificantAccountingPoliciesTable" id="md_SummaryOfSignificantAccountingPoliciesTable" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrldt:hypercubeItem"/>
  <element name="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"/>
  <element name="UnrecognizedTaxBenefitsImpactEffectiveTaxRate" id="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="instant" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="UnsecuredRevolvingCreditFacilityMember" id="md_UnsecuredRevolvingCreditFacilityMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
</schema>
</XBRL>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.CAL
<SEQUENCE>13
<FILENAME>md-20181231_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: 4 -->
<!-- Creation date: 2019-02-13T01:59:33Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
<linkbase xmlns="http://www.xbrl.org/2003/linkbase"
  xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
  xmlns:xlink="http://www.w3.org/1999/xlink"
  xsi:schemaLocation="http://www.xbrl.org/2003/linkbase http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd">
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DocumentandEntityInformation" roleURI="http://www.mednax.com/taxonomy/role/DocumentandEntityInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfFinancialPositionClassified" roleURI="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassified"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfFinancialPositionClassifiedParen" roleURI="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassifiedParenthetical"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfIncomeAlternative" roleURI="http://www.mednax.com/taxonomy/role/StatementOfIncomeAlternative"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfShareholdersEquityAndOtherComprehensiveIncome" roleURI="http://www.mednax.com/taxonomy/role/StatementOfShareholdersEquityAndOtherComprehensiveIncome"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfCashFlowsIndirect" roleURI="http://www.mednax.com/taxonomy/role/StatementOfCashFlowsIndirect"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine" roleURI="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureInvestmentsScheduleOfInvestments" roleURI="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfInvestments"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments" roleURI="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment" roleURI="http://www.mednax.com/taxonomy/role/DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosurePropertyAndEquipmentAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosurePropertyAndEquipmentAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureBusinessAcquisitionsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureBusinessAcquisitionsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureGoodwillAndIntangibleAssetsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccruedProfessionalLiabilitiesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards" roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards" roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommonStockRepurchaseProgramsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommonStockRepurchaseProgramsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureRetirementPlansAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureRetirementPlansAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommitmentsAndContingenciesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsNatureOfOperations" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsNatureOfOperations"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsIncomeTaxDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsEarningsPerShareTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsEarningsPerShareTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsCommonStockRepurchasesTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommonStockRepurchasesTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables"/>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DocumentandEntityInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassified">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" xlink:label="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableNetCurrent" xlink:label="us-gaap_AccountsReceivableNetCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccruedIncomeTaxesCurrent" xlink:label="us-gaap_AccruedIncomeTaxesCurrent"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesNoncurrent" xlink:label="us-gaap_DeferredTaxLiabilitiesNoncurrent"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HeldToMaturitySecuritiesNoncurrent" xlink:label="us-gaap_HeldToMaturitySecuritiesNoncurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Liabilities" xlink:label="us-gaap_Liabilities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquity" xlink:label="us-gaap_LiabilitiesAndStockholdersEquity"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesCurrent" xlink:label="us-gaap_LiabilitiesCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent" xlink:label="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" xlink:label="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LongTermLineOfCredit" xlink:label="us-gaap_LongTermLineOfCredit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Assets" xlink:to="us-gaap_AssetsCurrent" order="1.0700" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Assets" xlink:to="us-gaap_RestrictedCashNoncurrent" order="1.0800" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Assets" xlink:to="us-gaap_HeldToMaturitySecuritiesNoncurrent" order="1.0900" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Assets" xlink:to="us-gaap_PropertyPlantAndEquipmentNet" order="1.1000" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Assets" xlink:to="us-gaap_Goodwill" order="1.1100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Assets" xlink:to="us-gaap_FiniteLivedIntangibleAssetsNet" order="1.1200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Assets" xlink:to="us-gaap_OtherAssetsNoncurrent" order="1.1300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AssetsCurrent" xlink:to="us-gaap_CashAndCashEquivalentsAtCarryingValue" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AssetsCurrent" xlink:to="us-gaap_RestrictedCashCurrent" order="1.0200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AssetsCurrent" xlink:to="us-gaap_HeldToMaturitySecuritiesCurrent" order="1.0300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AssetsCurrent" xlink:to="us-gaap_AccountsReceivableNetCurrent" order="1.0400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AssetsCurrent" xlink:to="us-gaap_PrepaidExpenseCurrent" order="1.0500" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AssetsCurrent" xlink:to="us-gaap_OtherAssetsCurrent" order="1.0600" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Liabilities" xlink:to="us-gaap_LiabilitiesCurrent" order="1.1700" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Liabilities" xlink:to="us-gaap_LongTermLineOfCredit" order="1.1800" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Liabilities" xlink:to="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" order="1.1900" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Liabilities" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent" order="1.2000" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Liabilities" xlink:to="us-gaap_DeferredTaxLiabilitiesNoncurrent" order="1.2100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_Liabilities" xlink:to="us-gaap_OtherLiabilitiesNoncurrent" order="1.2200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_LiabilitiesAndStockholdersEquity" xlink:to="us-gaap_Liabilities" order="1.2300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_LiabilitiesAndStockholdersEquity" xlink:to="us-gaap_CommitmentsAndContingencies" order="1.2400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_LiabilitiesAndStockholdersEquity" xlink:to="us-gaap_StockholdersEquity" order="1.2900" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_LiabilitiesCurrent" xlink:to="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" order="1.1400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_LiabilitiesCurrent" xlink:to="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent" order="1.1500" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_LiabilitiesCurrent" xlink:to="us-gaap_AccruedIncomeTaxesCurrent" order="1.1600" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_StockholdersEquity" xlink:to="us-gaap_PreferredStockValue" order="1.2500" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_StockholdersEquity" xlink:to="us-gaap_CommonStockValue" order="1.2600" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_StockholdersEquity" xlink:to="us-gaap_AdditionalPaidInCapitalCommonStock" order="1.2700" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_StockholdersEquity" xlink:to="us-gaap_RetainedEarningsAccumulatedDeficit" order="1.2800" weight="1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassifiedParenthetical">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfIncomeAlternative">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DepreciationDepletionAndAmortization" xlink:label="us-gaap_DepreciationDepletionAndAmortization"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeLossFromEquityMethodInvestments" xlink:label="us-gaap_IncomeLossFromEquityMethodInvestments"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InterestExpense" xlink:label="us-gaap_InterestExpense"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentIncomeNet" xlink:label="us-gaap_InvestmentIncomeNet"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLoss" xlink:label="us-gaap_NetIncomeLoss"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PracticeSalariesAndBenefits" xlink:label="md_PracticeSalariesAndBenefits"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PracticeSuppliesAndOtherOperatingExpenses" xlink:label="md_PracticeSuppliesAndOtherOperatingExpenses"/>
    <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"/>
    <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"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:to="us-gaap_OperatingIncomeLoss" order="1.0700" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:to="us-gaap_NonoperatingIncomeExpense" order="1.1100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetIncomeLoss" xlink:to="us-gaap_ProfitLoss" order="1.1400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetIncomeLoss" xlink:to="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" order="1.1500" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NonoperatingIncomeExpense" xlink:to="us-gaap_InvestmentIncomeNet" order="1.0800" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NonoperatingIncomeExpense" xlink:to="us-gaap_InterestExpense" order="1.0900" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NonoperatingIncomeExpense" xlink:to="us-gaap_IncomeLossFromEquityMethodInvestments" order="1.1000" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingExpenses" xlink:to="md_PracticeSalariesAndBenefits" order="1.0200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingExpenses" xlink:to="md_PracticeSuppliesAndOtherOperatingExpenses" order="1.0300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingExpenses" xlink:to="us-gaap_GeneralAndAdministrativeExpense" order="1.0400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingExpenses" xlink:to="us-gaap_DepreciationDepletionAndAmortization" order="1.0500" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingIncomeLoss" xlink:to="us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingIncomeLoss" xlink:to="us-gaap_OperatingExpenses" order="1.0600" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_ProfitLoss" xlink:to="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" order="1.1200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_ProfitLoss" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="1.1300" weight="-1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfShareholdersEquityAndOtherComprehensiveIncome">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfCashFlowsIndirect">
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredIncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DepreciationDepletionAndAmortization" xlink:label="us-gaap_DepreciationDepletionAndAmortization"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities" xlink:label="us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities" xlink:label="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccountsReceivable" xlink:label="us-gaap_IncreaseDecreaseInAccountsReceivable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable" xlink:label="us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve" xlink:label="us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInOtherNoncurrentAssets" xlink:label="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInOtherOperatingLiabilities" xlink:label="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets" xlink:label="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivities"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PaymentsOfFinancingCosts" xlink:label="us-gaap_PaymentsOfFinancingCosts"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt" xlink:label="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensation" xlink:label="us-gaap_ShareBasedCompensation"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivities" order="1.1500" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivities" order="1.2200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivities" order="1.3300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:to="us-gaap_ProceedsFromLinesOfCredit" order="1.2300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:to="us-gaap_RepaymentsOfLinesOfCredit" order="1.2400" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:to="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt" order="1.2500" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:to="us-gaap_PaymentsOfFinancingCosts" order="1.2600" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:to="us-gaap_PaymentForContingentConsiderationLiabilityFinancingActivities" order="1.2700" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:to="us-gaap_RepaymentsOfLongTermCapitalLeaseObligations" order="1.2800" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:to="us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities" order="1.2900" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:to="us-gaap_ProceedsFromIssuanceOfCommonStock" order="1.3000" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:to="us-gaap_ProceedsFromMinorityShareholders" order="1.3100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:to="us-gaap_PaymentsForRepurchaseOfCommonStock" order="1.3200" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:to="us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired" order="1.1600" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:to="us-gaap_PaymentsToAcquireInvestments" order="1.1700" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:to="us-gaap_ProceedsFromSaleMaturityAndCollectionsOfInvestments" order="1.1800" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:to="us-gaap_PaymentsToAcquireOtherPropertyPlantAndEquipment" order="1.1900" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:to="us-gaap_ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets" order="1.2000" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:to="us-gaap_PaymentsForProceedsFromOtherInvestingActivities" order="1.2100" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_ProfitLoss" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_DepreciationDepletionAndAmortization" order="1.0200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_AmortizationOfFinancingCostsAndDiscounts" order="1.0300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_ShareBasedCompensation" order="1.0400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_DeferredIncomeTaxExpenseBenefit" order="1.0500" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_OtherNoncashIncomeExpense" order="1.0600" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_IncreaseDecreaseInAccountsReceivable" order="1.0700" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets" order="1.0800" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets" order="1.0900" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities" order="1.1000" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable" order="1.1100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_PaymentForContingentConsiderationLiabilityOperatingActivities" order="1.1200" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve" order="1.1300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities" order="1.1400" weight="1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfInvestments">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments">
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HeldToMaturitySecuritiesNoncurrent" xlink:label="us-gaap_HeldToMaturitySecuritiesNoncurrent"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_HeldToMaturitySecuritiesNoncurrent" xlink:to="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_HeldToMaturitySecuritiesNoncurrent" xlink:to="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount" order="1.0200" weight="1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableGrossCurrent" xlink:label="us-gaap_AccountsReceivableGrossCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableNetCurrent" xlink:label="us-gaap_AccountsReceivableNetCurrent"/>
    <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"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AccountsReceivableNetCurrent" xlink:to="us-gaap_AccountsReceivableGrossCurrent" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AccountsReceivableNetCurrent" xlink:to="us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent" order="1.0200" weight="-1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BuildingsAndImprovementsGross" xlink:label="us-gaap_BuildingsAndImprovementsGross"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FixturesAndEquipmentGross" xlink:label="us-gaap_FixturesAndEquipmentGross"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Land" xlink:label="us-gaap_Land"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentGross" xlink:label="us-gaap_PropertyPlantAndEquipmentGross"/>
    <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"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_PropertyPlantAndEquipmentGross" xlink:to="us-gaap_BuildingsAndImprovementsGross" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_PropertyPlantAndEquipmentGross" xlink:to="us-gaap_Land" order="1.0200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_PropertyPlantAndEquipmentGross" xlink:to="us-gaap_FixturesAndEquipmentGross" order="1.0300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_PropertyPlantAndEquipmentNet" xlink:to="us-gaap_PropertyPlantAndEquipmentGross" order="1.0400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_PropertyPlantAndEquipmentNet" xlink:to="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" order="1.0500" weight="-1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosurePropertyAndEquipmentAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureBusinessAcquisitionsAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsGross" xlink:label="us-gaap_FiniteLivedIntangibleAssetsGross"/>
    <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"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_FiniteLivedIntangibleAssetsNet" xlink:to="us-gaap_FiniteLivedIntangibleAssetsGross" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_FiniteLivedIntangibleAssetsNet" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" order="1.0200" weight="-1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableCurrent" xlink:label="us-gaap_AccountsPayableCurrent"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccruedContingentConsiderationLiabilityCurrent" xlink:label="md_AccruedContingentConsiderationLiabilityCurrent"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccruedPayrollTaxesAndBenefitsCurrent" xlink:label="md_AccruedPayrollTaxesAndBenefitsCurrent"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InterestPayableCurrent" xlink:label="us-gaap_InterestPayableCurrent"/>
    <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"/>
    <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"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:to="us-gaap_AccountsPayableCurrent" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:to="us-gaap_AccruedSalariesCurrent" order="1.0200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:to="md_AccruedPayrollTaxesAndBenefitsCurrent" order="1.0300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent" order="1.0400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:to="md_AccruedContingentConsiderationLiabilityCurrent" order="1.0500" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:to="us-gaap_InterestPayableCurrent" order="1.0600" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:to="us-gaap_OtherAccruedLiabilitiesCurrent" order="1.0700" weight="1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredNet" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredNet"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_MalpracticeLossContingencyProvisionForLosses" xlink:label="md_MalpracticeLossContingencyProvisionForLosses"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ProvisionAdjustmentForLossesRelatedToCurrentYear" xlink:label="md_ProvisionAdjustmentForLossesRelatedToCurrentYear"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ProvisionAdjustmentForLossesRelatedToPriorYear" xlink:label="md_ProvisionAdjustmentForLossesRelatedToPriorYear"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_MalpracticeLossContingencyClaimsIncurredNet" xlink:to="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod" order="1.0600" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_MalpracticeLossContingencyClaimsIncurredNet" xlink:to="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods" order="1.0700" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="md_MalpracticeLossContingencyProvisionForLosses" xlink:to="md_ProvisionAdjustmentForLossesRelatedToCurrentYear" order="1.0300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="md_MalpracticeLossContingencyProvisionForLosses" xlink:to="md_ProvisionAdjustmentForLossesRelatedToPriorYear" order="1.0400" weight="1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeaseObligations" xlink:label="us-gaap_CapitalLeaseObligations"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeaseObligationsCurrent" xlink:label="us-gaap_CapitalLeaseObligationsCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeaseObligationsNoncurrent" xlink:label="us-gaap_CapitalLeaseObligationsNoncurrent"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_CapitalLeaseObligations" xlink:to="us-gaap_CapitalLeaseObligationsCurrent" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_CapitalLeaseObligations" xlink:to="us-gaap_CapitalLeaseObligationsNoncurrent" order="1.0200" weight="1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CurrentFederalTaxExpenseBenefit" xlink:label="us-gaap_CurrentFederalTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CurrentStateAndLocalTaxExpenseBenefit" xlink:label="us-gaap_CurrentStateAndLocalTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredFederalIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredFederalIncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations" xlink:label="us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations" xlink:label="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations" xlink:to="us-gaap_CurrentFederalTaxExpenseBenefit" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations" xlink:to="us-gaap_DeferredFederalIncomeTaxExpenseBenefit" order="1.0200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_IncomeTaxExpenseBenefit" xlink:to="us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations" order="1.0300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_IncomeTaxExpenseBenefit" xlink:to="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations" order="1.0600" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations" xlink:to="us-gaap_CurrentStateAndLocalTaxExpenseBenefit" order="1.0400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations" xlink:to="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" order="1.0500" weight="1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:label="us-gaap_EffectiveIncomeTaxRateContinuingOperations"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes" order="1.0200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense" order="1.0300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments" order="1.0400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance" order="1.0500" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent" order="1.0600" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate" order="1.0700" weight="1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredIncomeTaxLiabilities" xlink:label="us-gaap_DeferredIncomeTaxLiabilities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsGross" xlink:label="us-gaap_DeferredTaxAssetsGross"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsNet" xlink:label="us-gaap_DeferredTaxAssetsNet"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOther" xlink:label="us-gaap_DeferredTaxAssetsOther"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment" xlink:label="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsValuationAllowance" xlink:label="us-gaap_DeferredTaxAssetsValuationAllowance"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilities" xlink:label="us-gaap_DeferredTaxLiabilities"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DeferredTaxLiabilitiesChangeInAccountingMethod" xlink:label="md_DeferredTaxLiabilitiesChangeInAccountingMethod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" xlink:label="us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" xlink:label="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesOther" xlink:label="us-gaap_DeferredTaxLiabilitiesOther"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredIncomeTaxLiabilities" xlink:to="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" order="1.1000" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredIncomeTaxLiabilities" xlink:to="md_DeferredTaxLiabilitiesChangeInAccountingMethod" order="1.1100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredIncomeTaxLiabilities" xlink:to="us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" order="1.1200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredIncomeTaxLiabilities" xlink:to="us-gaap_DeferredTaxLiabilitiesOther" order="1.1300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredTaxAssetsGross" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredTaxAssetsGross" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves" order="1.0200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredTaxAssetsGross" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" order="1.0300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredTaxAssetsGross" xlink:to="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" order="1.0400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredTaxAssetsGross" xlink:to="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment" order="1.0500" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredTaxAssetsGross" xlink:to="us-gaap_DeferredTaxAssetsOther" order="1.0600" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredTaxAssetsNet" xlink:to="us-gaap_DeferredTaxAssetsGross" order="1.0700" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredTaxAssetsNet" xlink:to="us-gaap_DeferredTaxAssetsValuationAllowance" order="1.0800" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredTaxLiabilities" xlink:to="us-gaap_DeferredTaxAssetsNet" order="1.0900" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_DeferredTaxLiabilities" xlink:to="us-gaap_DeferredIncomeTaxLiabilities" order="1.1400" weight="1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" xlink:label="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:to="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" order="1.0200" weight="1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommonStockRepurchaseProgramsAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureRetirementPlansAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesAdditionalInformation">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" order="1.0100" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" order="1.0200" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" order="1.0300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" order="1.0400" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" order="1.0500" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" order="1.0600" weight="1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLoss" xlink:label="us-gaap_NetIncomeLoss"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest"/>
    <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"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetIncomeLoss" xlink:to="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" order="1.1300" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetIncomeLoss" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="1.1400" weight="-1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetIncomeLoss" xlink:to="us-gaap_ProfitLoss" order="1.1600" weight="1.00" priority="2" use="optional"/>
    <calculationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/summation-item" xlink:from="us-gaap_NetIncomeLoss" xlink:to="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" order="1.1700" weight="-1.00" priority="2" use="optional"/>
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsNatureOfOperations">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommonStockRepurchasesTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock">
  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables">
  </calculationLink>
</linkbase>
</XBRL>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.DEF
<SEQUENCE>14
<FILENAME>md-20181231_def.xml
<DESCRIPTION>XBRL TAXONOMY EXTENSION DEFINITION LINKBASE
<TEXT>
<XBRL>
<?xml version="1.0" encoding="US-ASCII"?>
<!-- DFS Xcelerate Taxonomy Definition Linkbase - http://www.dfsco.com/financial-services/ -->
<!-- Version: 6.23.6 -->
<!-- Round: 4 -->
<!-- Creation date: 2019-02-13T01:59:33Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
<linkbase xmlns="http://www.xbrl.org/2003/linkbase"
  xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
  xmlns:xlink="http://www.w3.org/1999/xlink"
  xmlns:xbrldt="http://xbrl.org/2005/xbrldt"
  xsi:schemaLocation="http://www.xbrl.org/2003/linkbase http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd">
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DocumentandEntityInformation" roleURI="http://www.mednax.com/taxonomy/role/DocumentandEntityInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfFinancialPositionClassified" roleURI="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassified"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfFinancialPositionClassifiedParen" roleURI="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassifiedParenthetical"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfIncomeAlternative" roleURI="http://www.mednax.com/taxonomy/role/StatementOfIncomeAlternative"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfShareholdersEquityAndOtherComprehensiveIncome" roleURI="http://www.mednax.com/taxonomy/role/StatementOfShareholdersEquityAndOtherComprehensiveIncome"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfCashFlowsIndirect" roleURI="http://www.mednax.com/taxonomy/role/StatementOfCashFlowsIndirect"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine" roleURI="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureInvestmentsScheduleOfInvestments" roleURI="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfInvestments"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments" roleURI="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment" roleURI="http://www.mednax.com/taxonomy/role/DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosurePropertyAndEquipmentAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosurePropertyAndEquipmentAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureBusinessAcquisitionsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureBusinessAcquisitionsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureGoodwillAndIntangibleAssetsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccruedProfessionalLiabilitiesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards" roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards" roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommonStockRepurchaseProgramsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommonStockRepurchaseProgramsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureRetirementPlansAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureRetirementPlansAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommitmentsAndContingenciesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsNatureOfOperations" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsNatureOfOperations"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsIncomeTaxDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsEarningsPerShareTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsEarningsPerShareTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsCommonStockRepurchasesTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommonStockRepurchasesTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables"/>
  <arcroleRef xlink:type="simple" xlink:href="http://www.xbrl.org/2005/xbrldt-2005.xsd#all" arcroleURI="http://xbrl.org/int/dim/arcrole/all"/>
  <arcroleRef xlink:type="simple" xlink:href="http://www.xbrl.org/2005/xbrldt-2005.xsd#dimension-default" arcroleURI="http://xbrl.org/int/dim/arcrole/dimension-default"/>
  <arcroleRef xlink:type="simple" xlink:href="http://www.xbrl.org/2005/xbrldt-2005.xsd#dimension-domain" arcroleURI="http://xbrl.org/int/dim/arcrole/dimension-domain"/>
  <arcroleRef xlink:type="simple" xlink:href="http://www.xbrl.org/2005/xbrldt-2005.xsd#domain-member" arcroleURI="http://xbrl.org/int/dim/arcrole/domain-member"/>
  <arcroleRef xlink:type="simple" xlink:href="http://www.xbrl.org/2005/xbrldt-2005.xsd#hypercube-dimension" arcroleURI="http://xbrl.org/int/dim/arcrole/hypercube-dimension"/>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DocumentandEntityInformation">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassified">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassifiedParenthetical">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfIncomeAlternative">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfShareholdersEquityAndOtherComprehensiveIncome">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdditionalPaidInCapitalMember" xlink:label="us-gaap_AdditionalPaidInCapitalMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:label="us-gaap_EquityComponentDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NoncontrollingInterestMember" xlink:label="us-gaap_NoncontrollingInterestMember"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RetainedEarningsMember" xlink:label="us-gaap_RetainedEarningsMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharesIssued" xlink:label="us-gaap_SharesIssued"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" xlink:label="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" xlink:label="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_StockIssuedDuringPeriodSharesStockSwaps" xlink:label="md_StockIssuedDuringPeriodSharesStockSwaps"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" xlink:label="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_StockIssuedDuringPeriodValueStockSwaps" xlink:label="md_StockIssuedDuringPeriodValueStockSwaps"/>
    <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"/>
    <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"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="1.2000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_AdditionalPaidInCapitalMember" order="1.2100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_RetainedEarningsMember" order="1.2200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_NoncontrollingInterestMember" order="1.2300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StatementTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_SharesIssued" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ProfitLoss" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross" order="1.0600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross" order="1.0700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration" order="1.0800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration" order="1.0900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" order="1.1000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="md_StockIssuedDuringPeriodValueStockSwaps" order="1.1100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="md_StockIssuedDuringPeriodSharesStockSwaps" order="1.1200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" order="1.1300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" order="1.1400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodValue" order="1.1500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodShares" order="1.1600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" order="1.1700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="1.0000" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfCashFlowsIndirect">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableMember" xlink:label="us-gaap_AccountsReceivableMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BuildingMember" xlink:label="us-gaap_BuildingMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_BusinessCombinationContingentConsiderationArrangementsTimePeriod" xlink:label="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized" xlink:label="us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_CashAndCashEquivalentsMaturityDescription" xlink:label="md_CashAndCashEquivalentsMaturityDescription"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashSurrenderValueFairValueDisclosure" xlink:label="us-gaap_CashSurrenderValueFairValueDisclosure"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ComputerEquipmentMember" xlink:label="us-gaap_ComputerEquipmentMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByTypeAxis" xlink:label="us-gaap_ConcentrationRiskByTypeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:label="us-gaap_ConcentrationRiskPercentage1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskTypeDomain" xlink:label="us-gaap_ConcentrationRiskTypeDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskTypeDomain" xlink:label="us-gaap_ConcentrationRiskTypeDomain_2"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquipmentMember" xlink:label="us-gaap_EquipmentMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_EquityMethodInvesteeNameDomain" xlink:label="srt_EquityMethodInvesteeNameDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_EquityMethodInvesteeNameDomain" xlink:label="srt_EquityMethodInvesteeNameDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityMethodInvestmentOwnershipPercentage" xlink:label="us-gaap_EquityMethodInvestmentOwnershipPercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FurnitureAndFixturesMember" xlink:label="us-gaap_FurnitureAndFixturesMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GovernmentContractsConcentrationRiskMember" xlink:label="us-gaap_GovernmentContractsConcentrationRiskMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_LongTermInvestmentsMaturityPeriod" xlink:label="md_LongTermInvestmentsMaturityPeriod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_MoneyMarketFundsAtFairValue" xlink:label="md_MoneyMarketFundsAtFairValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:label="us-gaap_PropertyPlantAndEquipmentUsefulLife"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:label="srt_RangeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis" xlink:label="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ShortTermInvestmentMaturityPeriod" xlink:label="md_ShortTermInvestmentMaturityPeriod"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" xlink:label="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SoftwareAndSoftwareDevelopmentCostsMember" xlink:label="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:label="md_SummaryOfSignificantAccountingPoliciesLineItems"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SummaryOfSignificantAccountingPoliciesTable" xlink:label="md_SummaryOfSignificantAccountingPoliciesTable"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_UnnamedCorporateJointVentureMember" xlink:label="md_UnnamedCorporateJointVentureMember"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="us-gaap_AccountsReceivableMember" order="1.1400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:to="us-gaap_ConcentrationRiskBenchmarkDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:to="us-gaap_ConcentrationRiskBenchmarkDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_ConcentrationRiskByTypeAxis" xlink:to="us-gaap_ConcentrationRiskTypeDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_ConcentrationRiskByTypeAxis" xlink:to="us-gaap_ConcentrationRiskTypeDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_GovernmentContractsConcentrationRiskMember" order="1.1500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" order="1.1800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" order="1.2100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_EquityMethodInvesteeNameDomain" xlink:to="md_UnnamedCorporateJointVentureMember" order="1.1300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_BuildingMember" order="1.1700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_EquipmentMember" order="1.2000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_ComputerEquipmentMember" order="1.2200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember" order="1.2300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_FurnitureAndFixturesMember" order="1.2400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="1.1600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="1.1900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis" xlink:to="srt_EquityMethodInvesteeNameDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis" xlink:to="srt_EquityMethodInvesteeNameDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_SummaryOfSignificantAccountingPoliciesTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_EquityMethodInvestmentOwnershipPercentage" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_ConcentrationRiskPercentage1" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_CashAndCashEquivalentsMaturityDescription" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_LongTermInvestmentsMaturityPeriod" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_ShortTermInvestmentMaturityPeriod" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentUsefulLife" order="1.0600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod" order="1.0700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetUsefulLife" order="1.0800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_MoneyMarketFundsAtFairValue" order="1.0900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_CashSurrenderValueFairValueDisclosure" order="1.1000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized" order="1.1100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_DebtInstrumentInterestRateStatedPercentage" order="1.1200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="srt_RangeAxis" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis" order="2.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_ConcentrationRiskByTypeAxis" order="3.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_ConcentrationRiskByBenchmarkAxis" order="4.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis" order="5.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_CreditFacilityAxis" order="6.0000" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AnesthesiologyMember" xlink:label="md_AnesthesiologyMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByTypeAxis" xlink:label="us-gaap_ConcentrationRiskByTypeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:label="us-gaap_ConcentrationRiskPercentage1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskTypeDomain" xlink:label="us-gaap_ConcentrationRiskTypeDomain"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_MaternalFetalMedicineMember" xlink:label="md_MaternalFetalMedicineMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NeonatologyAndOtherPediatricSubspecialtiesMember" xlink:label="md_NeonatologyAndOtherPediatricSubspecialtiesMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PediatricCardiologyMember" xlink:label="md_PediatricCardiologyMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProductConcentrationRiskMember" xlink:label="us-gaap_ProductConcentrationRiskMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductOrServiceAxis" xlink:label="srt_ProductOrServiceAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:label="srt_ProductsAndServicesDomain"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_RadiologyAndTeleradiologyMember" xlink:label="md_RadiologyAndTeleradiologyMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SalesRevenueServicesNetMember" xlink:label="us-gaap_SalesRevenueServicesNetMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" xlink:label="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SegmentReportingInformationLineItems" xlink:label="us-gaap_SegmentReportingInformationLineItems"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="us-gaap_SalesRevenueServicesNetMember" order="1.0800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:to="us-gaap_ConcentrationRiskBenchmarkDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_ConcentrationRiskByTypeAxis" xlink:to="us-gaap_ConcentrationRiskTypeDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_ProductConcentrationRiskMember" order="1.0900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_NeonatologyAndOtherPediatricSubspecialtiesMember" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_AnesthesiologyMember" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_RadiologyAndTeleradiologyMember" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_MaternalFetalMedicineMember" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_ProductsAndServicesDomain" xlink:to="us-gaap_ManagementServiceMember" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_PediatricCardiologyMember" order="1.0600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" xlink:to="us-gaap_ConcentrationRiskByTypeAxis" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" xlink:to="us-gaap_ConcentrationRiskByBenchmarkAxis" order="2.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" xlink:to="srt_ProductOrServiceAxis" order="3.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="us-gaap_SegmentReportingInformationLineItems" xlink:to="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_SegmentReportingInformationLineItems" xlink:to="us-gaap_ConcentrationRiskPercentage1" order="1.0700" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfInvestments">
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HeldToMaturitySecuritiesNoncurrent" xlink:label="us-gaap_HeldToMaturitySecuritiesNoncurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentTypeAxis" xlink:label="us-gaap_InvestmentTypeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentTypeCategorizationMember" xlink:label="us-gaap_InvestmentTypeCategorizationMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentTypeCategorizationMember" xlink:label="us-gaap_InvestmentTypeCategorizationMember_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems" xlink:label="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems"/>
    <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"/>
    <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"/>
    <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"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_InvestmentTypeAxis" xlink:to="us-gaap_InvestmentTypeCategorizationMember" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_InvestmentTypeAxis" xlink:to="us-gaap_InvestmentTypeCategorizationMember_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_USStatesAndPoliticalSubdivisionsMember" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_USGovernmentSponsoredEnterprisesDebtSecuritiesMember" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_CertificatesOfDepositMember" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems" xlink:to="us-gaap_ScheduleOfHeldToMaturitySecuritiesTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems" xlink:to="us-gaap_HeldToMaturitySecuritiesCurrent" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems" xlink:to="us-gaap_HeldToMaturitySecuritiesNoncurrent" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfHeldToMaturitySecuritiesTable" xlink:to="us-gaap_InvestmentTypeAxis" order="1.0000" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisaggregationOfRevenueAbstract" xlink:label="us-gaap_DisaggregationOfRevenueAbstract"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_HospitalsContractsMember" xlink:label="md_HospitalsContractsMember"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductOrServiceAxis" xlink:label="srt_ProductOrServiceAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:label="srt_ProductsAndServicesDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:label="srt_ProductsAndServicesDomain_2"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ScheduleOfFinancingReceivablesLineItems" xlink:label="md_ScheduleOfFinancingReceivablesLineItems"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DisaggregationOfRevenueAbstract" xlink:to="us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_ProductsAndServicesDomain" xlink:to="us-gaap_HealthCarePatientServiceMember" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_HospitalsContractsMember" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_ProductsAndServicesDomain" xlink:to="us-gaap_ManagementServiceMember" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable" xlink:to="srt_ProductOrServiceAxis" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="md_ScheduleOfFinancingReceivablesLineItems" xlink:to="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_ScheduleOfFinancingReceivablesLineItems" xlink:to="us-gaap_DisaggregationOfRevenueAbstract" order="1.0500" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ContractedManagedCareMember" xlink:label="md_ContractedManagedCareMember"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:label="us-gaap_HealthCareOrganizationRevenueSourcesDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:label="us-gaap_HealthCareOrganizationRevenueSourcesDomain_2"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PercentageOfNetPatientServiceRevenueByTypeOfPayor" xlink:label="md_PercentageOfNetPatientServiceRevenueByTypeOfPayor"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable" xlink:label="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SelfPayMember" xlink:label="us-gaap_SelfPayMember"/>
    <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"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems" xlink:to="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems" xlink:to="md_PercentageOfNetPatientServiceRevenueByTypeOfPayor" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesAxis" xlink:to="us-gaap_HealthCareOrganizationRevenueSourcesDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesAxis" xlink:to="us-gaap_HealthCareOrganizationRevenueSourcesDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:to="md_ContractedManagedCareMember" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:to="us-gaap_GovernmentMember" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:to="us-gaap_ThirdPartyPayorMember" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:to="us-gaap_SelfPayMember" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable" xlink:to="us-gaap_HealthCareOrganizationRevenueSourcesAxis" order="1.0000" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueAdditionalInformation">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosurePropertyAndEquipmentAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Depreciation" xlink:label="us-gaap_Depreciation"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" xlink:label="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentGross" xlink:label="us-gaap_PropertyPlantAndEquipmentGross"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentLineItems" xlink:label="us-gaap_PropertyPlantAndEquipmentLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:label="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentGross" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_Depreciation" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis" order="1.0000" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureBusinessAcquisitionsAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup" xlink:label="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionAcquireeDomain" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionAcquireeDomain" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionAxis" xlink:label="us-gaap_BusinessAcquisitionAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:label="us-gaap_BusinessAcquisitionLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationConsiderationTransferred1" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1" xlink:label="us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DeconsolidationPercentage" xlink:label="md_DeconsolidationPercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityMethodInvestmentOwnershipPercentage" xlink:label="us-gaap_EquityMethodInvestmentOwnershipPercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAcquiredDuringPeriod" xlink:label="us-gaap_GoodwillAcquiredDuringPeriod"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfMaternalfetalMedicinePracticesAcquired" xlink:label="md_NumberOfMaternalfetalMedicinePracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfNeonatologyPracticesAcquired" xlink:label="md_NumberOfNeonatologyPracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfPediatricMultiSpecialtyPracticesAcquired" xlink:label="md_NumberOfPediatricMultiSpecialtyPracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfPediatricSubspecialtyPracticesAcquired" xlink:label="md_NumberOfPediatricSubspecialtyPracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfPhysicianGroupPracticesAcquired" xlink:label="md_NumberOfPhysicianGroupPracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfRadiologyPracticesAcquired" xlink:label="md_NumberOfRadiologyPracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions" xlink:label="md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PaymentsToAcquireBusinessesGross" xlink:label="us-gaap_PaymentsToAcquireBusinessesGross"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PhysicianGroupMember" xlink:label="md_PhysicianGroupMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PriorPeriodAcquisitionsMember" xlink:label="md_PriorPeriodAcquisitionsMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SaleOfMinorityInterestPercentage" xlink:label="md_SaleOfMinorityInterestPercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:to="md_PhysicianGroupMember" order="1.2300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:to="md_PriorPeriodAcquisitionsMember" order="1.2400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="us-gaap_BusinessAcquisitionAcquireeDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="us-gaap_BusinessAcquisitionAcquireeDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfPhysicianGroupPracticesAcquired" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfNeonatologyPracticesAcquired" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfPediatricSubspecialtyPracticesAcquired" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfRadiologyPracticesAcquired" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationConsiderationTransferred1" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_GoodwillAcquiredDuringPeriod" order="1.0600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" order="1.0700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets" order="1.0800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther" order="1.0900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_PaymentsForPreviousAcquisition" order="1.1000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions" order="1.1100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1" order="1.1200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets" order="1.1300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities" order="1.1400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_GoodwillPurchaseAccountingAdjustments" order="1.1500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_PaymentsToAcquireBusinessesGross" order="1.1600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup" order="1.1700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_EquityMethodInvestmentOwnershipPercentage" order="1.1800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfMaternalfetalMedicinePracticesAcquired" order="1.1900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfPediatricMultiSpecialtyPracticesAcquired" order="1.2000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_SaleOfMinorityInterestPercentage" order="1.2100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_DeconsolidationPercentage" order="1.2200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionAxis" order="1.0000" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" xlink:label="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AmortizationOfIntangibleAssets" xlink:label="us-gaap_AmortizationOfIntangibleAssets"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount" xlink:label="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FinitelivedIntangibleAssetsAcquired1" xlink:label="us-gaap_FinitelivedIntangibleAssetsAcquired1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_2"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:label="md_GoodwillAndOtherIntangibleAssetsLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillPeriodIncreaseDecrease" xlink:label="us-gaap_GoodwillPeriodIncreaseDecrease"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ManagementServicesReportingUnitMember" xlink:label="md_ManagementServicesReportingUnitMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PhysicianAndHospitalAgreementsMember" xlink:label="md_PhysicianAndHospitalAgreementsMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SegmentDomain" xlink:label="us-gaap_SegmentDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SegmentDomain" xlink:label="us-gaap_SegmentDomain_2"/>
    <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"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="md_PhysicianAndHospitalAgreementsMember" order="1.0800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_Goodwill" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_GoodwillPeriodIncreaseDecrease" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_FinitelivedIntangibleAssetsAcquired1" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_AmortizationOfIntangibleAssets" order="1.0600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_StatementBusinessSegmentsAxis" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" order="2.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_SegmentDomain" xlink:to="md_ManagementServicesReportingUnitMember" order="1.0700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_StatementBusinessSegmentsAxis" xlink:to="us-gaap_SegmentDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_StatementBusinessSegmentsAxis" xlink:to="us-gaap_SegmentDomain_2" order="1.0000" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CustomerRelationshipsMember" xlink:label="us-gaap_CustomerRelationshipsMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsGross" xlink:label="us-gaap_FiniteLivedIntangibleAssetsGross"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:label="us-gaap_FiniteLivedIntangibleAssetsLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PatentedAndOtherTechnologyMember" xlink:label="md_PatentedAndOtherTechnologyMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PhysicianAndHospitalAgreementsMember" xlink:label="md_PhysicianAndHospitalAgreementsMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TradeNamesMember" xlink:label="us-gaap_TradeNamesMember"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsGross" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" order="1.0600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsNet" order="1.0700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="md_PhysicianAndHospitalAgreementsMember" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="us-gaap_CustomerRelationshipsMember" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="us-gaap_TradeNamesMember" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="md_PatentedAndOtherTechnologyMember" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" order="1.0000" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesAdditionalInformation">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AlternateBaseRateMember" xlink:label="md_AlternateBaseRateMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ApplicableMarginRateMember" xlink:label="md_ApplicableMarginRateMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ChangeInControlMember" xlink:label="md_ChangeInControlMember"/>
    <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"/>
    <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"/>
    <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_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentAxis" xlink:label="us-gaap_DebtInstrumentAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" xlink:label="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentDescriptionOfVariableRateBasis" xlink:label="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentFaceAmount" xlink:label="us-gaap_DebtInstrumentFaceAmount"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentLineItems" xlink:label="us-gaap_DebtInstrumentLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentMaturityDateDescription" xlink:label="us-gaap_DebtInstrumentMaturityDateDescription"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentMaturityYear" xlink:label="md_DebtInstrumentMaturityYear"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentNameDomain" xlink:label="us-gaap_DebtInstrumentNameDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentNameDomain" xlink:label="us-gaap_DebtInstrumentNameDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodAxis" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodAxis"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember" xlink:label="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodFiveMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodFiveMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodFourMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodFourMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodOneMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodOneMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentRedemptionPeriodSixAndThereafterMember" xlink:label="md_DebtInstrumentRedemptionPeriodSixAndThereafterMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember" xlink:label="md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodThreeMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodThreeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodTwoMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodTwoMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPricePercentage" xlink:label="us-gaap_DebtInstrumentRedemptionPricePercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed" xlink:label="us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FederalFundsEffectiveSwapRateMember" xlink:label="us-gaap_FederalFundsEffectiveSwapRateMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LetterOfCreditMember" xlink:label="us-gaap_LetterOfCreditMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LettersOfCreditOutstandingAmount" xlink:label="us-gaap_LettersOfCreditOutstandingAmount"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityCommitmentFeePercentage" xlink:label="us-gaap_LineOfCreditFacilityCommitmentFeePercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityExpirationDate1" xlink:label="us-gaap_LineOfCreditFacilityExpirationDate1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" xlink:label="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity" xlink:label="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityTable" xlink:label="us-gaap_LineOfCreditFacilityTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LondonInterbankOfferedRateLIBORMember" xlink:label="us-gaap_LondonInterbankOfferedRateLIBORMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LongTermDebt" xlink:label="us-gaap_LongTermDebt"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherOwnershipInterestsByNameAxis" xlink:label="us-gaap_OtherOwnershipInterestsByNameAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherOwnershipInterestsNameDomain" xlink:label="us-gaap_OtherOwnershipInterestsNameDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherOwnershipInterestsNameDomain" xlink:label="us-gaap_OtherOwnershipInterestsNameDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:label="srt_RangeMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" xlink:label="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioUnspecifiedDomain" xlink:label="us-gaap_ScenarioUnspecifiedDomain"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" xlink:label="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementScenarioAxis" xlink:label="us-gaap_StatementScenarioAxis"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_UnsecuredRevolvingCreditFacilityMember" xlink:label="md_UnsecuredRevolvingCreditFacilityMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_VariableRateAxis" xlink:label="us-gaap_VariableRateAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_VariableRateDomain" xlink:label="us-gaap_VariableRateDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_VariableRateDomain" xlink:label="us-gaap_VariableRateDomain_2"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_UnsecuredRevolvingCreditFacilityMember" order="1.1500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="us-gaap_LetterOfCreditMember" order="1.2200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" order="1.2700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" order="1.2900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_DebtInstrumentAxis" xlink:to="us-gaap_DebtInstrumentNameDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_DebtInstrumentAxis" xlink:to="us-gaap_DebtInstrumentNameDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LineOfCreditFacilityTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LineOfCreditFacilityExpirationDate1" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LineOfCreditFacilityCommitmentFeePercentage" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentFaceAmount" order="1.0600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentInterestRateStatedPercentage" order="1.0700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentMaturityDateDescription" order="1.0800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed" order="1.0900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentRedemptionPricePercentage" order="1.1000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="md_DebtInstrumentMaturityYear" order="1.1100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LongTermDebt" order="1.1200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LettersOfCreditOutstandingAmount" order="1.1300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity" order="1.1400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="md_AlternateBaseRateMember" order="1.1600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="md_ApplicableMarginRateMember" order="1.2400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodAxis" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodAxis" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodOneMember" order="1.1900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodTwoMember" order="1.2600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember" order="1.2800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember" order="1.3000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodThreeMember" order="1.3100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodFourMember" order="1.3200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodFiveMember" order="1.3300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="md_DebtInstrumentRedemptionPeriodSixAndThereafterMember" order="1.3400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_CreditFacilityAxis" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_DebtInstrumentAxis" order="2.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_VariableRateAxis" order="3.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodAxis" order="4.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_OtherOwnershipInterestsByNameAxis" order="5.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="srt_RangeAxis" order="6.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_StatementScenarioAxis" order="7.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_OtherOwnershipInterestsByNameAxis" xlink:to="us-gaap_OtherOwnershipInterestsNameDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_OtherOwnershipInterestsByNameAxis" xlink:to="us-gaap_OtherOwnershipInterestsNameDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_OtherOwnershipInterestsNameDomain" xlink:to="md_ChangeInControlMember" order="1.2100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="1.1800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="1.2500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ScenarioUnspecifiedDomain" xlink:to="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" order="1.2000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_StatementScenarioAxis" xlink:to="us-gaap_ScenarioUnspecifiedDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_VariableRateDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_VariableRateDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_VariableRateDomain" xlink:to="us-gaap_FederalFundsEffectiveSwapRateMember" order="1.1700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_VariableRateDomain" xlink:to="us-gaap_LondonInterbankOfferedRateLIBORMember" order="1.2300" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt">
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentCarryingAmount" xlink:label="us-gaap_DebtInstrumentCarryingAmount"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentLineItems" xlink:label="us-gaap_DebtInstrumentLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentTable" xlink:label="us-gaap_DebtInstrumentTable"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LongTermDebt" xlink:label="us-gaap_LongTermDebt"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevolvingCreditFacilityMember" xlink:label="us-gaap_RevolvingCreditFacilityMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnamortizedDebtIssuanceExpense" xlink:label="us-gaap_UnamortizedDebtIssuanceExpense"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="us-gaap_RevolvingCreditFacilityMember" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentCarryingAmount" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_UnamortizedDebtIssuanceExpense" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LongTermDebt" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_CreditFacilityAxis" order="1.0000" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes">
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentFairValueLineItems" xlink:label="md_DebtInstrumentFairValueLineItems"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentFairValueTable" xlink:label="md_DebtInstrumentFairValueTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EstimateOfFairValueFairValueDisclosureMember" xlink:label="us-gaap_EstimateOfFairValueFairValueDisclosureMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:label="us-gaap_FairValueByFairValueHierarchyLevelAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueByMeasurementBasisAxis" xlink:label="us-gaap_FairValueByMeasurementBasisAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueDisclosureItemAmountsDomain" xlink:label="us-gaap_FairValueDisclosureItemAmountsDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueInputsLevel2Member" xlink:label="us-gaap_FairValueInputsLevel2Member"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:label="us-gaap_FairValueMeasurementsFairValueHierarchyDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:label="us-gaap_FairValueMeasurementsFairValueHierarchyDomain_2"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PortionAtFairValueFairValueDisclosureMember" xlink:label="us-gaap_PortionAtFairValueFairValueDisclosureMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" xlink:label="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="md_DebtInstrumentFairValueLineItems" xlink:to="md_DebtInstrumentFairValueTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_DebtInstrumentFairValueLineItems" xlink:to="us-gaap_NotesPayableFairValueDisclosure" order="1.0600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_DebtInstrumentFairValueTable" xlink:to="us-gaap_CreditFacilityAxis" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_DebtInstrumentFairValueTable" xlink:to="us-gaap_FairValueByFairValueHierarchyLevelAxis" order="2.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_DebtInstrumentFairValueTable" xlink:to="us-gaap_FairValueByMeasurementBasisAxis" order="3.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:to="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:to="us-gaap_FairValueMeasurementsFairValueHierarchyDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_FairValueByMeasurementBasisAxis" xlink:to="us-gaap_PortionAtFairValueFairValueDisclosureMember" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_FairValueByMeasurementBasisAxis" xlink:to="us-gaap_FairValueDisclosureItemAmountsDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_FairValueDisclosureItemAmountsDomain" xlink:to="us-gaap_PortionAtFairValueFairValueDisclosureMember" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_FairValueDisclosureItemAmountsDomain" xlink:to="us-gaap_EstimateOfFairValueFairValueDisclosureMember" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:to="us-gaap_FairValueInputsLevel2Member" order="1.0500" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet" xlink:label="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ChangeInAccountingEstimateByTypeAxis" xlink:label="us-gaap_ChangeInAccountingEstimateByTypeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ChangeInAccountingEstimateTypeDomain" xlink:label="us-gaap_ChangeInAccountingEstimateTypeDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ChangeInAccountingEstimateTypeDomain" xlink:label="us-gaap_ChangeInAccountingEstimateTypeDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DeferredTaxLiabilitiesChangeInAccountingMethod" xlink:label="md_DeferredTaxLiabilitiesChangeInAccountingMethod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarliestTaxYearMember" xlink:label="us-gaap_EarliestTaxYearMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:label="us-gaap_EffectiveIncomeTaxRateContinuingOperations"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued" xlink:label="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability" xlink:label="us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncomeTaxExpenseForExcessTaxDeficiencies" xlink:label="md_IncomeTaxExpenseForExcessTaxDeficiencies"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncomeTaxLineItems" xlink:label="md_IncomeTaxLineItems"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncomeTaxTable" xlink:label="md_IncomeTaxTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInDeferredLiabilities" xlink:label="us-gaap_IncreaseDecreaseInDeferredLiabilities"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:label="md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" xlink:label="md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_InterestAndPenaltiesMember" xlink:label="md_InterestAndPenaltiesMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_InternalRevenueCodeSection481Member" xlink:label="md_InternalRevenueCodeSection481Member"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LatestTaxYearMember" xlink:label="us-gaap_LatestTaxYearMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NetOperatingLossCarryForwardsExpirationDate" xlink:label="md_NetOperatingLossCarryForwardsExpirationDate"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OpenTaxYear" xlink:label="us-gaap_OpenTaxYear"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLossCarryforwards" xlink:label="us-gaap_OperatingLossCarryforwards"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:label="srt_RangeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:label="srt_RangeMember_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis" xlink:label="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioForecastMember" xlink:label="us-gaap_ScenarioForecastMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioUnspecifiedDomain" xlink:label="us-gaap_ScenarioUnspecifiedDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioUnspecifiedDomain" xlink:label="us-gaap_ScenarioUnspecifiedDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain" xlink:label="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain" xlink:label="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementScenarioAxis" xlink:label="us-gaap_StatementScenarioAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxPeriodAxis" xlink:label="us-gaap_TaxPeriodAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxPeriodDomain" xlink:label="us-gaap_TaxPeriodDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxPeriodDomain" xlink:label="us-gaap_TaxPeriodDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefits" xlink:label="us-gaap_UnrecognizedTaxBenefits"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate" xlink:label="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease" xlink:label="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate" xlink:label="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_ChangeInAccountingEstimateByTypeAxis" xlink:to="us-gaap_ChangeInAccountingEstimateTypeDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_ChangeInAccountingEstimateByTypeAxis" xlink:to="us-gaap_ChangeInAccountingEstimateTypeDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ChangeInAccountingEstimateTypeDomain" xlink:to="md_InternalRevenueCodeSection481Member" order="1.2100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="md_IncomeTaxLineItems" xlink:to="md_IncomeTaxTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_EffectiveIncomeTaxRateContinuingOperations" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_IncreaseDecreaseInDeferredLiabilities" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" order="1.0600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="md_DeferredTaxLiabilitiesChangeInAccountingMethod" order="1.0700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" order="1.0800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet" order="1.0900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="md_IncomeTaxExpenseForExcessTaxDeficiencies" order="1.1000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_OperatingLossCarryforwards" order="1.1100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="md_NetOperatingLossCarryForwardsExpirationDate" order="1.1200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration" order="1.1300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration" order="1.1400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefits" order="1.1500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate" order="1.1600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease" order="1.1700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="1.1800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued" order="1.1900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_OpenTaxYear" order="1.2000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_IncomeTaxTable" xlink:to="srt_RangeAxis" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_IncomeTaxTable" xlink:to="us-gaap_StatementScenarioAxis" order="2.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_IncomeTaxTable" xlink:to="us-gaap_ChangeInAccountingEstimateByTypeAxis" order="3.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_IncomeTaxTable" xlink:to="us-gaap_TaxPeriodAxis" order="4.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_IncomeTaxTable" xlink:to="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis" order="5.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="1.2200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="1.2600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis" xlink:to="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis" xlink:to="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ScenarioUnspecifiedDomain" xlink:to="us-gaap_ScenarioForecastMember" order="1.2300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain" xlink:to="md_InterestAndPenaltiesMember" order="1.2400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_StatementScenarioAxis" xlink:to="us-gaap_ScenarioUnspecifiedDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_StatementScenarioAxis" xlink:to="us-gaap_ScenarioUnspecifiedDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_TaxPeriodAxis" xlink:to="us-gaap_TaxPeriodDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_TaxPeriodAxis" xlink:to="us-gaap_TaxPeriodDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_TaxPeriodDomain" xlink:to="us-gaap_EarliestTaxYearMember" order="1.2500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_TaxPeriodDomain" xlink:to="us-gaap_LatestTaxYearMember" order="1.2700" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AmendedAndRestatedTwoThousandEightPlanMember" xlink:label="md_AmendedAndRestatedTwoThousandEightPlanMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:label="us-gaap_AwardTypeAxis"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockOptionMember" xlink:label="us-gaap_EmployeeStockOptionMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember"/>
    <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"/>
    <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"/>
    <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_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation" xlink:label="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:label="srt_RangeMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_RestrictedAndDeferredStockUnitsMember" xlink:label="md_RestrictedAndDeferredStockUnitsMember"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:label="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember" xlink:label="md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_PlanNameAxis" xlink:to="us-gaap_PlanNameDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_PlanNameAxis" xlink:to="us-gaap_PlanNameDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PlanNameDomain" xlink:to="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember" order="1.1800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PlanNameDomain" xlink:to="md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember" order="1.2000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PlanNameDomain" xlink:to="md_AmendedAndRestatedTwoThousandEightPlanMember" order="1.2100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_PlanNameDomain" xlink:to="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember" order="1.2300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="1.1700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_PlanNameAxis" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_AwardTypeAxis" order="2.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="srt_RangeAxis" order="3.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_CommonStockSharesAuthorized" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans" order="1.0600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" order="1.0700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_AllocatedShareBasedCompensationExpense" order="1.0800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue" order="1.0900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" order="1.1000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1" order="1.1100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions" order="1.1200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" order="1.1300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" order="1.1400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation" order="1.1500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_EmployeeStockOptionMember" order="1.1600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockMember" order="1.1900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="md_RestrictedAndDeferredStockUnitsMember" order="1.2200" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommonStockRepurchaseProgramsAdditionalInformation">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AcceleratedShareRepurchaseAgreementsMember" xlink:label="md_AcceleratedShareRepurchaseAgreementsMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt" xlink:label="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:label="us-gaap_AwardTypeAxis"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_CommonStockLineItems" xlink:label="md_CommonStockLineItems"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_CommonStockTable" xlink:label="md_CommonStockTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:label="us-gaap_EquityComponentDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:label="us-gaap_EquityComponentDomain_2"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareRepurchaseProgramAxis" xlink:label="us-gaap_ShareRepurchaseProgramAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareRepurchaseProgramDomain" xlink:label="us-gaap_ShareRepurchaseProgramDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareRepurchaseProgramDomain" xlink:label="us-gaap_ShareRepurchaseProgramDomain_2"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockRepurchaseProgramAuthorizedAmount1" xlink:label="us-gaap_StockRepurchaseProgramAuthorizedAmount1"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/all" xlink:from="md_CommonStockLineItems" xlink:to="md_CommonStockTable" order="100.0000" xbrldt:closed="true" xbrldt:contextElement="segment" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_StockRepurchaseProgramAuthorizedAmount1" order="1.0100" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt" order="1.0200" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodValue" order="1.0300" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodShares" order="1.0400" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation" order="1.0500" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation" order="1.0600" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_CommonStockTable" xlink:to="us-gaap_ShareRepurchaseProgramAxis" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_CommonStockTable" xlink:to="us-gaap_AwardTypeAxis" order="2.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/hypercube-dimension" xlink:from="md_CommonStockTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="3.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="1.0800" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockMember" order="1.0900" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_ShareRepurchaseProgramAxis" xlink:to="us-gaap_ShareRepurchaseProgramDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_ShareRepurchaseProgramAxis" xlink:to="us-gaap_ShareRepurchaseProgramDomain_2" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/domain-member" xlink:from="us-gaap_ShareRepurchaseProgramDomain" xlink:to="md_AcceleratedShareRepurchaseAgreementsMember" order="1.0700" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-default" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="1.0000" priority="2" use="optional"/>
    <definitionArc xlink:type="arc" xlink:arcrole="http://xbrl.org/int/dim/arcrole/dimension-domain" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain_2" order="1.0000" priority="2" use="optional"/>
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureRetirementPlansAdditionalInformation">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesAdditionalInformation">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsNatureOfOperations">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommonStockRepurchasesTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock">
  </definitionLink>
  <definitionLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables">
  </definitionLink>
</linkbase>
</XBRL>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.LAB
<SEQUENCE>15
<FILENAME>md-20181231_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: 4 -->
<!-- Creation date: 2019-02-13T01:59:33Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
<linkbase xmlns="http://www.xbrl.org/2003/linkbase"
  xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
  xmlns:xlink="http://www.w3.org/1999/xlink"
  xsi:schemaLocation="http://www.xbrl.org/2003/linkbase http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd">
  <roleRef xlink:type="simple" xlink:href="http://www.xbrl.org/lrr/role/negated-2009-12-16.xsd#negatedLabel" roleURI="http://www.xbrl.org/2009/role/negatedLabel"/>
  <roleRef xlink:type="simple" xlink:href="http://www.xbrl.org/lrr/role/negated-2009-12-16.xsd#negatedTerseLabel" roleURI="http://www.xbrl.org/2009/role/negatedTerseLabel"/>
  <roleRef xlink:type="simple" xlink:href="http://www.xbrl.org/lrr/role/negated-2009-12-16.xsd#negatedTotalLabel" roleURI="http://www.xbrl.org/2009/role/negatedTotalLabel"/>
  <labelLink xlink:type="extended" xlink:role="http://www.xbrl.org/2003/role/link">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AcceleratedShareRepurchaseAgreementsMember" xlink:label="md_AcceleratedShareRepurchaseAgreementsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AcceleratedShareRepurchaseAgreementsMember_lbl" xml:lang="en-US" id="id_14062202_3275817_3_1">Accelerated Share Repurchase Agreements [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AcceleratedShareRepurchaseAgreementsMember_lbl" xml:lang="en-US" id="id_14062202_3275817_1_1">Accelerated Share Repurchase Agreements [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AcceleratedShareRepurchaseAgreementsMember_lbl" xml:lang="en-US" id="id_14062202_3275817_2_1">Accelerated Share Repurchase (ASR) Agreements [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AcceleratedShareRepurchaseAgreementsMember" xlink:to="md_AcceleratedShareRepurchaseAgreementsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt" xlink:label="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt_lbl" xml:lang="en-US" id="id_14062202_3063732_1_1">Accelerated Share Repurchases, Settlement (Payment) or Receipt</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt_lbl" xml:lang="en-US" id="id_14062202_3063732_2_1">Common stock purchase</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt" xlink:to="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="us-gaap_AccountingPoliciesAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountingPoliciesAbstract_lbl" xml:lang="en-US" id="id_14062202_3063306_1_1">Accounting Policies [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccountingPoliciesAbstract_lbl" xml:lang="en-US" id="id_14062202_3063306_2_1">Accounting Policies [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_AccountingPoliciesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsNotesLoansAndFinancingReceivableGrossAllowanceAndNetAbstract" xlink:label="us-gaap_AccountsNotesLoansAndFinancingReceivableGrossAllowanceAndNetAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsNotesLoansAndFinancingReceivableGrossAllowanceAndNetAbstract_lbl" xml:lang="en-US" id="id_14062202_3063323_1_1">Accounts, Notes, Loans and Financing Receivable, Gross, Allowance, and Net [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccountsNotesLoansAndFinancingReceivableGrossAllowanceAndNetAbstract_lbl" xml:lang="en-US" id="id_14062202_3063323_2_1">Accounts, Notes, Loans and Financing Receivable, Gross, Allowance, and Net [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsNotesLoansAndFinancingReceivableGrossAllowanceAndNetAbstract" xlink:to="us-gaap_AccountsNotesLoansAndFinancingReceivableGrossAllowanceAndNetAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent_lbl" xml:lang="en-US" id="id_14062202_3063965_1_1">Accounts Payable and Accrued Liabilities, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent_lbl" xml:lang="en-US" id="id_14062202_3063965_6_1">Accounts payable and accrued expenses, total</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:to="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3063328_1_1">Accounts Payable and Accrued Liabilities Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3063328_2_1">Accounts Payable and Accrued Expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" xlink:to="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" xlink:label="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent_lbl" xml:lang="en-US" id="id_14062202_3152529_3_1">Accounts payable and accrued liabilities excluding accrued income taxes current.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent_lbl" xml:lang="en-US" id="id_14062202_3152529_1_1">Accounts Payable and Accrued Liabilities Excluding Accrued Income Taxes Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent_lbl" xml:lang="en-US" id="id_14062202_3152529_2_1">Accounts payable and accrued expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" xlink:to="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableCurrent" xlink:label="us-gaap_AccountsPayableCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsPayableCurrent_lbl" xml:lang="en-US" id="id_14062202_3063969_1_1">Accounts Payable, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccountsPayableCurrent_lbl" xml:lang="en-US" id="id_14062202_3063969_2_1">Accounts payable</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsPayableCurrent" xlink:to="us-gaap_AccountsPayableCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccountsReceivableAndNetRevenueDisclosureTextBlock" xlink:label="md_AccountsReceivableAndNetRevenueDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccountsReceivableAndNetRevenueDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3340770_3_1">Accounts receivable and net revenue disclosure.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AccountsReceivableAndNetRevenueDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3340770_1_1">Accounts Receivable And Net Revenue Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AccountsReceivableAndNetRevenueDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3340770_2_1">Accounts Receivable and Net Revenue</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AccountsReceivableAndNetRevenueDisclosureTextBlock" xlink:to="md_AccountsReceivableAndNetRevenueDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableGrossCurrent" xlink:label="us-gaap_AccountsReceivableGrossCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsReceivableGrossCurrent_lbl" xml:lang="en-US" id="id_14062202_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_14062202_3063974_2_1">Gross accounts receivable</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsReceivableGrossCurrent" xlink:to="us-gaap_AccountsReceivableGrossCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableMember" xlink:label="us-gaap_AccountsReceivableMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsReceivableMember_lbl" xml:lang="en-US" id="id_14062202_3063975_1_1">Accounts Receivable [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccountsReceivableMember_lbl" xml:lang="en-US" id="id_14062202_3063975_2_1">Accounts Receivable [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccountsReceivableMember" xlink:to="us-gaap_AccountsReceivableMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableNetCurrent" xlink:label="us-gaap_AccountsReceivableNetCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccountsReceivableNetCurrent_lbl" xml:lang="en-US" id="id_14062202_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_3188883_2_1">Accrued contingent consideration</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AccruedContingentConsiderationLiabilityCurrent" xlink:to="md_AccruedContingentConsiderationLiabilityCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccruedIncomeTaxesCurrent" xlink:label="us-gaap_AccruedIncomeTaxesCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccruedIncomeTaxesCurrent_lbl" xml:lang="en-US" id="id_14062202_3063557_1_1">Accrued Income Taxes, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccruedIncomeTaxesCurrent_lbl" xml:lang="en-US" id="id_14062202_3063557_2_1">Income taxes payable</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccruedIncomeTaxesCurrent" xlink:to="us-gaap_AccruedIncomeTaxesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccruedPayrollTaxesAndBenefitsCurrent" xlink:label="md_AccruedPayrollTaxesAndBenefitsCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccruedPayrollTaxesAndBenefitsCurrent_lbl" xml:lang="en-US" id="id_14062202_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_14062202_3186005_1_1">Accrued Payroll Taxes And Benefits Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AccruedPayrollTaxesAndBenefitsCurrent_lbl" xml:lang="en-US" id="id_14062202_3186005_2_1">Accrued payroll taxes and benefits</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AccruedPayrollTaxesAndBenefitsCurrent" xlink:to="md_AccruedPayrollTaxesAndBenefitsCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition" xlink:label="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition_lbl" xml:lang="en-US" id="id_14062202_3102753_3_1">Accrued professional liabilities assumed through acquisition.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition_lbl" xml:lang="en-US" id="id_14062202_3102753_1_1">Accrued Professional Liabilities Assumed Through Acquisition</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition_lbl" xml:lang="en-US" id="id_14062202_3102753_2_1">Assumed liabilities through acquisition</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition" xlink:to="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccruedProfessionalLiability" xlink:label="md_AccruedProfessionalLiability"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccruedProfessionalLiability_lbl" xml:lang="en-US" id="id_14062202_3097642_3_1">Accrued professional liability.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AccruedProfessionalLiability_lbl" xml:lang="en-US" id="id_14062202_3097642_1_1">Accrued Professional Liability</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AccruedProfessionalLiability_lbl" xml:lang="en-US" id="id_14062202_3097642_2_1">Accrued professional liability incurred and loss reserves reported for claims</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AccruedProfessionalLiability" xlink:to="md_AccruedProfessionalLiability_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_3064004_1_1">Accrued Salaries, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccruedSalariesCurrent_lbl" xml:lang="en-US" id="id_14062202_3064004_2_1">Accrued salaries and bonuses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccruedSalariesCurrent" xlink:to="us-gaap_AccruedSalariesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_14062202_3063789_1_1">Accumulated Depreciation, Depletion and Amortization, Property, Plant, and Equipment</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_14062202_3063789_2_1">Accumulated depreciation of property and equipment held under capital leases</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_14062202_3063789_14_1">Accumulated depreciation</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:to="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" xlink:label="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife_lbl" xml:lang="en-US" id="id_14062202_3063796_1_1">Acquired Finite-lived Intangible Assets, Weighted Average Useful Life</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife_lbl" xml:lang="en-US" id="id_14062202_3063796_2_1">Weighted average amortization period</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" xlink:to="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_3063808_2_1">Additional paid-in capital</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdditionalPaidInCapitalCommonStock" xlink:to="us-gaap_AdditionalPaidInCapitalCommonStock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdditionalPaidInCapitalMember" xlink:label="us-gaap_AdditionalPaidInCapitalMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AdditionalPaidInCapitalMember_lbl" xml:lang="en-US" id="id_14062202_3063589_1_1">Additional Paid-in Capital [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdditionalPaidInCapitalMember_lbl" xml:lang="en-US" id="id_14062202_3063589_2_1">Additional Paid-in Capital [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdditionalPaidInCapitalMember" xlink:to="us-gaap_AdditionalPaidInCapitalMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_3063597_1_1">Adjustments Related to Tax Withholding for Share-based Compensation</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation_lbl" xml:lang="en-US" id="id_14062202_3063597_2_1">Amount withheld to satisfy minimum statutory tax withholding obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation" xlink:to="us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue_lbl" xml:lang="en-US" id="id_14062202_3063819_1_1">Adjustments to Additional Paid in Capital, Share-based Compensation, Requisite Service Period Recognition</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue_lbl" xml:lang="en-US" id="id_14062202_3063819_2_1">Stock-based compensation expense</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation_lbl" xml:lang="en-US" id="id_14062202_3063402_1_1">Adjustments to Additional Paid in Capital, Income Tax Benefit from Share-based Compensation</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation_lbl" xml:lang="en-US" id="id_14062202_3063402_2_1">Excess tax benefit related to employee stock incentive plans</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_3064049_1_1">Adjustments to Reconcile Net Income (Loss) to Cash Provided by (Used in) Operating Activities [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract_lbl" xml:lang="en-US" id="id_14062202_3064049_2_1">Adjustments to reconcile net income to net cash provided from operating activities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet" xlink:label="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet_lbl" xml:lang="en-US" id="id_14062202_3064050_1_1">Adjustment to Additional Paid in Capital, Income Tax Effect from Share-based Compensation, Net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet_lbl" xml:lang="en-US" id="id_14062202_3064050_2_1">Adjustment to additional paid-in capital for excess tax benefits related to stock-based awards</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet" xlink:to="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_14062202_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_14062202_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-20181231.xsd#md_AlternateBaseRateMember" xlink:label="md_AlternateBaseRateMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AlternateBaseRateMember_lbl" xml:lang="en-US" id="id_14062202_3320305_3_1">Alternate base rate.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AlternateBaseRateMember_lbl" xml:lang="en-US" id="id_14062202_3320305_1_1">Alternate Base Rate [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AlternateBaseRateMember_lbl" xml:lang="en-US" id="id_14062202_3320305_2_1">Alternate Base Rate [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AlternateBaseRateMember" xlink:to="md_AlternateBaseRateMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AmortizationOfIntangibleAssets" xlink:label="us-gaap_AmortizationOfIntangibleAssets"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AmortizationOfIntangibleAssets_lbl" xml:lang="en-US" id="id_14062202_3064105_1_1">Amortization of Intangible Assets</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AmortizationOfIntangibleAssets_lbl" xml:lang="en-US" id="id_14062202_3064105_2_1">Amortization expense for intangible assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AmortizationOfIntangibleAssets" xlink:to="us-gaap_AmortizationOfIntangibleAssets_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AnesthesiologyMember" xlink:label="md_AnesthesiologyMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AnesthesiologyMember_lbl" xml:lang="en-US" id="id_14062202_3253055_3_1">Anesthesiology.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AnesthesiologyMember_lbl" xml:lang="en-US" id="id_14062202_3253055_1_1">Anesthesiology [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AnesthesiologyMember_lbl" xml:lang="en-US" id="id_14062202_3253055_2_1">Anesthesiology [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AnesthesiologyMember" xlink:to="md_AnesthesiologyMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_3063481_2_1">Antidilutive securities not included in the diluted net income per common share calculation</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount" xlink:to="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ApplicableMarginRateMember" xlink:label="md_ApplicableMarginRateMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ApplicableMarginRateMember_lbl" xml:lang="en-US" id="id_14062202_3334909_3_1">Applicable margin rate.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ApplicableMarginRateMember_lbl" xml:lang="en-US" id="id_14062202_3334909_1_1">Applicable Margin Rate [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ApplicableMarginRateMember_lbl" xml:lang="en-US" id="id_14062202_3334909_2_1">Applicable Margin Rate [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ApplicableMarginRateMember" xlink:to="md_ApplicableMarginRateMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_3064144_1_1">Assets, Current [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AssetsCurrentAbstract_lbl" xml:lang="en-US" id="id_14062202_3064144_2_1">Current assets:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_AssetsCurrentAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup" xlink:label="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup_lbl" xml:lang="en-US" id="id_14062202_3063508_1_1">Assets Held-for-sale, Not Part of Disposal Group</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup_lbl" xml:lang="en-US" id="id_14062202_3063508_2_1">Assets held for sale</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup" xlink:to="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:label="us-gaap_AwardTypeAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AwardTypeAxis_lbl" xml:lang="en-US" id="id_14062202_3064218_1_1">Award Type [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AwardTypeAxis_lbl" xml:lang="en-US" id="id_14062202_3064218_2_1">Award Type [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_AwardTypeAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BuildingMember" xlink:label="us-gaap_BuildingMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BuildingMember_lbl" xml:lang="en-US" id="id_14062202_3064276_1_1">Building [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BuildingMember_lbl" xml:lang="en-US" id="id_14062202_3064276_2_1">Buildings [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BuildingMember" xlink:to="us-gaap_BuildingMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BuildingsAndImprovementsGross" xlink:label="us-gaap_BuildingsAndImprovementsGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BuildingsAndImprovementsGross_lbl" xml:lang="en-US" id="id_14062202_3064493_1_1">Buildings and Improvements, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BuildingsAndImprovementsGross_lbl" xml:lang="en-US" id="id_14062202_3064493_2_1">Building</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BuildingsAndImprovementsGross" xlink:to="us-gaap_BuildingsAndImprovementsGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionAcquireeDomain" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain_lbl" xml:lang="en-US" id="id_14062202_3064938_1_1">Business Acquisition, Acquiree [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain_lbl" xml:lang="en-US" id="id_14062202_3064938_2_1">Business Acquisition, Acquiree [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:to="us-gaap_BusinessAcquisitionAcquireeDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionAxis" xlink:label="us-gaap_BusinessAcquisitionAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessAcquisitionAxis_lbl" xml:lang="en-US" id="id_14062202_3064719_1_1">Business Acquisition [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessAcquisitionAxis_lbl" xml:lang="en-US" id="id_14062202_3064719_2_1">Business Acquisition [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="us-gaap_BusinessAcquisitionAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:label="us-gaap_BusinessAcquisitionLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessAcquisitionLineItems_lbl" xml:lang="en-US" id="id_14062202_3064278_1_1">Business Acquisition [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessAcquisitionLineItems_lbl" xml:lang="en-US" id="id_14062202_3064278_2_1">Business Acquisition [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessAcquisitionLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount" xlink:label="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount_lbl" xml:lang="en-US" id="id_14062202_3064725_1_1">Business Acquisition, Goodwill, Expected Tax Deductible Amount</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount_lbl" xml:lang="en-US" id="id_14062202_3064725_2_1">Goodwill deductible for tax purpose</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount" xlink:to="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationConsiderationTransferred1" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1_lbl" xml:lang="en-US" id="id_14062202_3064957_1_1">Business Combination, Consideration Transferred</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1_lbl" xml:lang="en-US" id="id_14062202_3064957_2_1">Total business acquisition consideration</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationConsiderationTransferred1" xlink:to="us-gaap_BusinessCombinationConsiderationTransferred1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1" xlink:label="us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1_lbl" xml:lang="en-US" id="id_14062202_3064301_1_1">Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration, Liability</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1_lbl" xml:lang="en-US" id="id_14062202_3064301_2_1">Change in the fair value of a contingent consideration</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1" xlink:to="us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_BusinessCombinationContingentConsiderationArrangementsTimePeriod" xlink:label="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod_lbl" xml:lang="en-US" id="id_14062202_3228396_3_1">Business combination, contingent consideration arrangements, time period.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod_lbl" xml:lang="en-US" id="id_14062202_3228396_1_1">Business Combination Contingent Consideration Arrangements Time Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod_lbl" xml:lang="en-US" id="id_14062202_3228396_2_1">Additional amounts to be paid in cash or common stock based on achievement of performance measures within period, maximum years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod" xlink:to="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationDisclosureTextBlock" xlink:label="us-gaap_BusinessCombinationDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3064965_1_1">Business Combination Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3064965_2_1">Business Acquisitions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationDisclosureTextBlock" xlink:to="us-gaap_BusinessCombinationDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized" xlink:label="us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized_lbl" xml:lang="en-US" id="id_14062202_3064737_1_1">Business Combination, Liabilities Arising from Contingencies, Amount Recognized</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized_lbl" xml:lang="en-US" id="id_14062202_3064737_2_1">Contingent consideration liabilities related to acquisitions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized" xlink:to="us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets_lbl" xml:lang="en-US" id="id_14062202_3064531_1_1">Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets_lbl" xml:lang="en-US" id="id_14062202_3064531_2_1">Decrease in current assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles_lbl" xml:lang="en-US" id="id_14062202_3064539_1_1">Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles_lbl" xml:lang="en-US" id="id_14062202_3064539_2_1">Other intangible assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets_lbl" xml:lang="en-US" id="id_14062202_3064751_1_1">Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Noncurrent Assets</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets_lbl" xml:lang="en-US" id="id_14062202_3064751_2_1">Decrease in noncurrent assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities_lbl" xml:lang="en-US" id="id_14062202_3064331_1_1">Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Noncurrent Liabilities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities_lbl" xml:lang="en-US" id="id_14062202_3064331_2_1">Decrease in noncurrent liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther_lbl" xml:lang="en-US" id="id_14062202_3064544_1_1">Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Noncurrent Liabilities, Other</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther_lbl" xml:lang="en-US" id="id_14062202_3064544_2_1">Other liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:label="us-gaap_BusinessCombinationsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationsAbstract_lbl" xml:lang="en-US" id="id_14062202_3064547_1_1">Business Combinations [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationsAbstract_lbl" xml:lang="en-US" id="id_14062202_3064547_2_1">Business Combinations [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_BusinessCombinationsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsPolicy" xlink:label="us-gaap_BusinessCombinationsPolicy"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_BusinessCombinationsPolicy_lbl" xml:lang="en-US" id="id_14062202_3064555_1_1">Business Combinations Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_BusinessCombinationsPolicy_lbl" xml:lang="en-US" id="id_14062202_3064555_2_1">Business Acquisitions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_BusinessCombinationsPolicy" xlink:to="us-gaap_BusinessCombinationsPolicy_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalExpendituresIncurredButNotYetPaid" xlink:label="us-gaap_CapitalExpendituresIncurredButNotYetPaid"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalExpendituresIncurredButNotYetPaid_lbl" xml:lang="en-US" id="id_14062202_3064354_1_1">Capital Expenditures Incurred but Not yet Paid</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalExpendituresIncurredButNotYetPaid_lbl" xml:lang="en-US" id="id_14062202_3064354_2_1">Property and equipment included in accounts payable</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalExpendituresIncurredButNotYetPaid" xlink:to="us-gaap_CapitalExpendituresIncurredButNotYetPaid_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeaseObligations" xlink:label="us-gaap_CapitalLeaseObligations"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeaseObligations_lbl" xml:lang="en-US" id="id_14062202_3064589_1_1">Capital Lease Obligations</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_CapitalLeaseObligations_lbl" xml:lang="en-US" id="id_14062202_3064589_6_1">Capital lease obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeaseObligations" xlink:to="us-gaap_CapitalLeaseObligations_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeaseObligationsCurrent" xlink:label="us-gaap_CapitalLeaseObligationsCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeaseObligationsCurrent_lbl" xml:lang="en-US" id="id_14062202_3064590_1_1">Capital Lease Obligations, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_CapitalLeaseObligationsCurrent_lbl" xml:lang="en-US" id="id_14062202_3064590_14_1">Less: Current portion</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeaseObligationsCurrent" xlink:to="us-gaap_CapitalLeaseObligationsCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeaseObligationsIncurred" xlink:label="us-gaap_CapitalLeaseObligationsIncurred"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeaseObligationsIncurred_lbl" xml:lang="en-US" id="id_14062202_3064795_1_1">Capital Lease Obligations Incurred</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalLeaseObligationsIncurred_lbl" xml:lang="en-US" id="id_14062202_3064795_2_1">Equipment financed through capital leases</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeaseObligationsIncurred" xlink:to="us-gaap_CapitalLeaseObligationsIncurred_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeaseObligationsNoncurrent" xlink:label="us-gaap_CapitalLeaseObligationsNoncurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeaseObligationsNoncurrent_lbl" xml:lang="en-US" id="id_14062202_3064591_1_1">Capital Lease Obligations, Noncurrent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalLeaseObligationsNoncurrent_lbl" xml:lang="en-US" id="id_14062202_3064591_2_1">Long-term portion</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeaseObligationsNoncurrent" xlink:to="us-gaap_CapitalLeaseObligationsNoncurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent_lbl" xml:lang="en-US" id="id_14062202_3065030_1_1">Capital Leases, Future Minimum Payments Due, Next Twelve Months</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent_lbl" xml:lang="en-US" id="id_14062202_3065030_2_1">2019</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent" xlink:to="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears_lbl" xml:lang="en-US" id="id_14062202_3065248_1_1">Capital Leases, Future Minimum Payments Due in Three Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears_lbl" xml:lang="en-US" id="id_14062202_3065248_2_1">2021</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears" xlink:to="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears_lbl" xml:lang="en-US" id="id_14062202_3065686_1_1">Capital Leases, Future Minimum Payments Due in Two Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears_lbl" xml:lang="en-US" id="id_14062202_3065686_2_1">2020</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears" xlink:to="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue_lbl" xml:lang="en-US" id="id_14062202_3065278_1_1">Cash and Cash Equivalents, at Carrying Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue_lbl" xml:lang="en-US" id="id_14062202_3065278_2_1">Cash and cash equivalents</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:to="us-gaap_CashAndCashEquivalentsAtCarryingValue_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_CashAndCashEquivalentsMaturityDescription" xlink:label="md_CashAndCashEquivalentsMaturityDescription"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_CashAndCashEquivalentsMaturityDescription_lbl" xml:lang="en-US" id="id_14062202_3209123_3_1">Cash and cash equivalents maturity description.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_CashAndCashEquivalentsMaturityDescription_lbl" xml:lang="en-US" id="id_14062202_3209123_1_1">Cash And Cash Equivalents Maturity Description</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_CashAndCashEquivalentsMaturityDescription_lbl" xml:lang="en-US" id="id_14062202_3209123_2_1">Cash and cash equivalents maturity description</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_CashAndCashEquivalentsMaturityDescription" xlink:to="md_CashAndCashEquivalentsMaturityDescription_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsPolicyTextBlock" xlink:label="us-gaap_CashAndCashEquivalentsPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashAndCashEquivalentsPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3065071_1_1">Cash and Cash Equivalents, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashAndCashEquivalentsPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3065071_2_1">Cash and Cash Equivalents</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashAndCashEquivalentsPolicyTextBlock" xlink:to="us-gaap_CashAndCashEquivalentsPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy" xlink:label="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy_lbl" xml:lang="en-US" id="id_14062202_3065072_1_1">Cash and Cash Equivalents, Restricted Cash and Cash Equivalents, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy_lbl" xml:lang="en-US" id="id_14062202_3065072_2_1">Restricted Cash</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy" xlink:to="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_lbl" xml:lang="en-US" id="id_14062202_3065291_1_1">Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_lbl" xml:lang="en-US" id="id_14062202_3065291_4_1">Cash, cash equivalents and restricted cash at end of year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_lbl" xml:lang="en-US" id="id_14062202_3065291_5_1">Cash, cash equivalents and restricted cash at beginning of year</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect_lbl" xml:lang="en-US" id="id_14062202_3065732_1_1">Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Period Increase (Decrease), Including Exchange Rate Effect</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect_lbl" xml:lang="en-US" id="id_14062202_3065732_6_1">Net (decrease) increase in cash and cash equivalents</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract" xlink:label="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3065735_1_1">Cash Flow, Noncash Investing and Financing Activities Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3065735_2_1">Non-cash investing and financing activities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract" xlink:to="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashSurrenderValueFairValueDisclosure" xlink:label="us-gaap_CashSurrenderValueFairValueDisclosure"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashSurrenderValueFairValueDisclosure_lbl" xml:lang="en-US" id="id_14062202_3065101_1_1">Cash Surrender Value, Fair Value Disclosure</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashSurrenderValueFairValueDisclosure_lbl" xml:lang="en-US" id="id_14062202_3065101_2_1">Cash surrender fair value of life insurance</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashSurrenderValueFairValueDisclosure" xlink:to="us-gaap_CashSurrenderValueFairValueDisclosure_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_ChangeInAccountingEstimateByTypeAxis" xlink:label="us-gaap_ChangeInAccountingEstimateByTypeAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ChangeInAccountingEstimateByTypeAxis_lbl" xml:lang="en-US" id="id_14062202_3065136_1_1">Change in Accounting Estimate by Type [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ChangeInAccountingEstimateByTypeAxis_lbl" xml:lang="en-US" id="id_14062202_3065136_2_1">Change in Accounting Estimate by Type [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ChangeInAccountingEstimateByTypeAxis" xlink:to="us-gaap_ChangeInAccountingEstimateByTypeAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ChangeInAccountingEstimateTypeDomain" xlink:label="us-gaap_ChangeInAccountingEstimateTypeDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ChangeInAccountingEstimateTypeDomain_lbl" xml:lang="en-US" id="id_14062202_3065793_1_1">Change in Accounting Estimate, Type [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ChangeInAccountingEstimateTypeDomain_lbl" xml:lang="en-US" id="id_14062202_3065793_2_1">Change in Accounting Estimate, Type [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ChangeInAccountingEstimateTypeDomain" xlink:to="us-gaap_ChangeInAccountingEstimateTypeDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ChangeInControlMember" xlink:label="md_ChangeInControlMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ChangeInControlMember_lbl" xml:lang="en-US" id="id_14062202_3252743_3_1">Change in control.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ChangeInControlMember_lbl" xml:lang="en-US" id="id_14062202_3252743_1_1">Change In Control [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ChangeInControlMember_lbl" xml:lang="en-US" id="id_14062202_3252743_2_1">Change In Control [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ChangeInControlMember" xlink:to="md_ChangeInControlMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_3348135_2_1">Common Stock Repurchase Programs</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_CommonStockRepurchasesTextBlock" xlink:to="md_CommonStockRepurchasesTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_CommonStockShareRepurchasesPolicyTextBlock" xlink:label="md_CommonStockShareRepurchasesPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_CommonStockShareRepurchasesPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3348938_3_1">Common stock share repurchases policy.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_CommonStockShareRepurchasesPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3348938_1_1">Common Stock Share Repurchases [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_CommonStockShareRepurchasesPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3348938_2_1">Common Stock Repurchases</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_CommonStockShareRepurchasesPolicyTextBlock" xlink:to="md_CommonStockShareRepurchasesPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_3065862_2_1">Common stock; $.01 par value; 200,000 shares authorized; 87,820 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="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:label="us-gaap_CompensationAndRetirementDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CompensationAndRetirementDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3065219_1_1">Retirement Benefits [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CompensationAndRetirementDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3065219_2_1">Retirement Benefits [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:to="us-gaap_CompensationAndRetirementDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ComputerEquipmentMember" xlink:label="us-gaap_ComputerEquipmentMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ComputerEquipmentMember_lbl" xml:lang="en-US" id="id_14062202_3065616_1_1">Computer Equipment [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ComputerEquipmentMember_lbl" xml:lang="en-US" id="id_14062202_3065616_2_1">Computer Equipment [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ComputerEquipmentMember" xlink:to="us-gaap_ComputerEquipmentMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain_lbl" xml:lang="en-US" id="id_14062202_3065437_1_1">Concentration Risk Benchmark [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain_lbl" xml:lang="en-US" id="id_14062202_3065437_2_1">Concentration Risk Benchmark [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="us-gaap_ConcentrationRiskBenchmarkDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis_lbl" xml:lang="en-US" id="id_14062202_3065617_1_1">Concentration Risk Benchmark [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis_lbl" xml:lang="en-US" id="id_14062202_3065617_2_1">Concentration Risk Benchmark [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:to="us-gaap_ConcentrationRiskByBenchmarkAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByTypeAxis" xlink:label="us-gaap_ConcentrationRiskByTypeAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConcentrationRiskByTypeAxis_lbl" xml:lang="en-US" id="id_14062202_3065618_1_1">Concentration Risk Type [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConcentrationRiskByTypeAxis_lbl" xml:lang="en-US" id="id_14062202_3065618_2_1">Concentration Risk Type [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConcentrationRiskByTypeAxis" xlink:to="us-gaap_ConcentrationRiskByTypeAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:label="us-gaap_ConcentrationRiskPercentage1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConcentrationRiskPercentage1_lbl" xml:lang="en-US" id="id_14062202_3065625_1_1">Concentration Risk, Percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConcentrationRiskPercentage1_lbl" xml:lang="en-US" id="id_14062202_3065625_2_1">Net revenue in percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_ConcentrationRiskPercentage1_lbl" xml:lang="en-US" id="id_14062202_3065625_12_1">Percentage of net accounts receivable</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConcentrationRiskPercentage1" xlink:to="us-gaap_ConcentrationRiskPercentage1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskTypeDomain" xlink:label="us-gaap_ConcentrationRiskTypeDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConcentrationRiskTypeDomain_lbl" xml:lang="en-US" id="id_14062202_3065233_1_1">Concentration Risk Type [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConcentrationRiskTypeDomain_lbl" xml:lang="en-US" id="id_14062202_3065233_2_1">Concentration Risk Type [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_ConcentrationRiskTypeDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConsolidationPolicyTextBlock" xlink:label="us-gaap_ConsolidationPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ConsolidationPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3066117_1_1">Consolidation, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ConsolidationPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3066117_2_1">Principles of Presentation</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ConsolidationPolicyTextBlock" xlink:to="us-gaap_ConsolidationPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CurrentFederalTaxExpenseBenefit" xlink:label="us-gaap_CurrentFederalTaxExpenseBenefit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CurrentFederalTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3066250_1_1">Current Federal Tax Expense (Benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CurrentFederalTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3066250_2_1">Federal, Current</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CurrentFederalTaxExpenseBenefit" xlink:to="us-gaap_CurrentFederalTaxExpenseBenefit_lbl"/>
    <loc xlink:type="locator" xlink:href="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_14062202_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_14062202_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_CurrentStateAndLocalTaxExpenseBenefit" xlink:label="us-gaap_CurrentStateAndLocalTaxExpenseBenefit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CurrentStateAndLocalTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3066412_1_1">Current State and Local Tax Expense (Benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CurrentStateAndLocalTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3066412_2_1">State, Current</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CurrentStateAndLocalTaxExpenseBenefit" xlink:to="us-gaap_CurrentStateAndLocalTaxExpenseBenefit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CustomerRelationshipsMember" xlink:label="us-gaap_CustomerRelationshipsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CustomerRelationshipsMember_lbl" xml:lang="en-US" id="id_14062202_3066421_1_1">Customer Relationships [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CustomerRelationshipsMember_lbl" xml:lang="en-US" id="id_14062202_3066421_2_1">Customer Relationships [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CustomerRelationshipsMember" xlink:to="us-gaap_CustomerRelationshipsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock" xlink:label="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock_lbl" xml:lang="en-US" id="id_14062202_3066053_1_1">Debt and Capital Leases Disclosures [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock_lbl" xml:lang="en-US" id="id_14062202_3066053_2_1">Line of Credit, Long-Term Debt and Capital Lease Obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock" xlink:to="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:label="us-gaap_DebtDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3066703_1_1">Debt Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3066703_2_1">Debt Disclosure [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_DebtDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentAxis" xlink:label="us-gaap_DebtInstrumentAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentAxis_lbl" xml:lang="en-US" id="id_14062202_3066061_1_1">Debt Instrument [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentAxis_lbl" xml:lang="en-US" id="id_14062202_3066061_2_1">Debt Instrument [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentAxis" xlink:to="us-gaap_DebtInstrumentAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" xlink:label="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1_lbl" xml:lang="en-US" id="id_14062202_3066062_1_1">Debt Instrument, Basis Spread on Variable Rate</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1_lbl" xml:lang="en-US" id="id_14062202_3066062_2_1">Debt instrument, variable interest rate</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" xlink:to="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentCarryingAmount" xlink:label="us-gaap_DebtInstrumentCarryingAmount"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentCarryingAmount_lbl" xml:lang="en-US" id="id_14062202_3066705_1_1">Long-term Debt, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentCarryingAmount_lbl" xml:lang="en-US" id="id_14062202_3066705_2_1">Debt instrument principal amount</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentCarryingAmount" xlink:to="us-gaap_DebtInstrumentCarryingAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentDescriptionOfVariableRateBasis" xlink:label="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis_lbl" xml:lang="en-US" id="id_14062202_3066710_1_1">Debt Instrument, Description of Variable Rate Basis</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis_lbl" xml:lang="en-US" id="id_14062202_3066710_2_1">Debt instrument, interest rate</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis" xlink:to="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentFaceAmount" xlink:label="us-gaap_DebtInstrumentFaceAmount"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentFaceAmount_lbl" xml:lang="en-US" id="id_14062202_3066711_1_1">Debt Instrument, Face Amount</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentFaceAmount_lbl" xml:lang="en-US" id="id_14062202_3066711_2_1">Aggregate principal amount of debt</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentFaceAmount" xlink:to="us-gaap_DebtInstrumentFaceAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentFairValueDisclosureAbstract" xlink:label="us-gaap_DebtInstrumentFairValueDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentFairValueDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3066074_1_1">Debt Instrument, Fair Value Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentFairValueDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3066074_2_1">Debt Instrument, Fair Value Disclosure [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentFairValueDisclosureAbstract" xlink:to="us-gaap_DebtInstrumentFairValueDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentFairValueLineItems" xlink:label="md_DebtInstrumentFairValueLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DebtInstrumentFairValueLineItems_lbl" xml:lang="en-US" id="id_14062202_3538154_3_1">Debt Instrument Fair Value [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DebtInstrumentFairValueLineItems_lbl" xml:lang="en-US" id="id_14062202_3538154_1_1">Debt Instrument Fair Value [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DebtInstrumentFairValueLineItems_lbl" xml:lang="en-US" id="id_14062202_3538154_2_1">Debt Instrument Fair Value [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DebtInstrumentFairValueLineItems" xlink:to="md_DebtInstrumentFairValueLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentFairValueTable" xlink:label="md_DebtInstrumentFairValueTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DebtInstrumentFairValueTable_lbl" xml:lang="en-US" id="id_14062202_3237721_3_1">Debt Instrument Fair Value [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DebtInstrumentFairValueTable_lbl" xml:lang="en-US" id="id_14062202_3237721_1_1">Debt Instrument Fair Value [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DebtInstrumentFairValueTable_lbl" xml:lang="en-US" id="id_14062202_3237721_2_1">Debt Instrument Fair Value [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DebtInstrumentFairValueTable" xlink:to="md_DebtInstrumentFairValueTable_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"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentInterestRateStatedPercentage_lbl" xml:lang="en-US" id="id_14062202_3066308_1_1">Debt Instrument, Interest Rate, Stated Percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentInterestRateStatedPercentage_lbl" xml:lang="en-US" id="id_14062202_3066308_2_1">Debt instrument interest rate</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentInterestRateStatedPercentage" xlink:to="us-gaap_DebtInstrumentInterestRateStatedPercentage_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentLineItems" xlink:label="us-gaap_DebtInstrumentLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentLineItems_lbl" xml:lang="en-US" id="id_14062202_3066464_1_1">Debt Instrument [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentLineItems_lbl" xml:lang="en-US" id="id_14062202_3066464_2_1">Debt Instrument [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentMaturityDateDescription" xlink:label="us-gaap_DebtInstrumentMaturityDateDescription"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentMaturityDateDescription_lbl" xml:lang="en-US" id="id_14062202_3066081_1_1">Debt Instrument, Maturity Date, Description</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentMaturityDateDescription_lbl" xml:lang="en-US" id="id_14062202_3066081_2_1">Debt instrument maturity date description</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentMaturityDateDescription" xlink:to="us-gaap_DebtInstrumentMaturityDateDescription_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentMaturityYear" xlink:label="md_DebtInstrumentMaturityYear"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DebtInstrumentMaturityYear_lbl" xml:lang="en-US" id="id_14062202_3215362_3_1">Debt instrument maturity year.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DebtInstrumentMaturityYear_lbl" xml:lang="en-US" id="id_14062202_3215362_1_1">Debt Instrument Maturity Year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DebtInstrumentMaturityYear_lbl" xml:lang="en-US" id="id_14062202_3215362_2_1">Debt instrument, maturity year</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DebtInstrumentMaturityYear" xlink:to="md_DebtInstrumentMaturityYear_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentNameDomain" xlink:label="us-gaap_DebtInstrumentNameDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentNameDomain_lbl" xml:lang="en-US" id="id_14062202_3066716_1_1">Debt Instrument, Name [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentNameDomain_lbl" xml:lang="en-US" id="id_14062202_3066716_2_1">Debt Instrument, Name [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="us-gaap_DebtInstrumentNameDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodAxis" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodAxis_lbl" xml:lang="en-US" id="id_14062202_3066719_1_1">Debt Instrument, Redemption, Period [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodAxis_lbl" xml:lang="en-US" id="id_14062202_3066719_2_1">Debt Instrument, Redemption, Period [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodAxis" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember" xlink:label="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember_lbl" xml:lang="en-US" id="id_14062202_3538549_3_1">Debt instrument redemption period before two thousand twenty two.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember_lbl" xml:lang="en-US" id="id_14062202_3538549_1_1">Debt Instrument Redemption Period Before Two Thousand Twenty Two [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember_lbl" xml:lang="en-US" id="id_14062202_3538549_2_1">Redemption Before 2022 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember" xlink:to="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodDomain_lbl" xml:lang="en-US" id="id_14062202_3066470_1_1">Debt Instrument, Redemption, Period [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodDomain_lbl" xml:lang="en-US" id="id_14062202_3066470_2_1">Debt Instrument, Redemption, Period [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodFiveMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodFiveMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodFiveMember_lbl" xml:lang="en-US" id="id_14062202_3066720_1_1">Debt Instrument, Redemption, Period Five [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodFiveMember_lbl" xml:lang="en-US" id="id_14062202_3066720_2_1">Redemption in 2024 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodFiveMember" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodFiveMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodFourMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodFourMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodFourMember_lbl" xml:lang="en-US" id="id_14062202_3066314_1_1">Debt Instrument, Redemption, Period Four [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodFourMember_lbl" xml:lang="en-US" id="id_14062202_3066314_2_1">Redemption in 2023 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodFourMember" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodFourMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodOneMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodOneMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodOneMember_lbl" xml:lang="en-US" id="id_14062202_3066721_1_1">Debt Instrument, Redemption, Period One [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodOneMember_lbl" xml:lang="en-US" id="id_14062202_3066721_2_1">Redemption in 2019 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodOneMember" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodOneMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentRedemptionPeriodSixAndThereafterMember" xlink:label="md_DebtInstrumentRedemptionPeriodSixAndThereafterMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DebtInstrumentRedemptionPeriodSixAndThereafterMember_lbl" xml:lang="en-US" id="id_14062202_3255258_3_1">Debt instrument redemption period six and thereafter.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DebtInstrumentRedemptionPeriodSixAndThereafterMember_lbl" xml:lang="en-US" id="id_14062202_3255258_1_1">Debt Instrument Redemption Period Six And Thereafter [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DebtInstrumentRedemptionPeriodSixAndThereafterMember_lbl" xml:lang="en-US" id="id_14062202_3255258_2_1">Redemption in 2025 and Thereafter [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DebtInstrumentRedemptionPeriodSixAndThereafterMember" xlink:to="md_DebtInstrumentRedemptionPeriodSixAndThereafterMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember" xlink:label="md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember_lbl" xml:lang="en-US" id="id_14062202_3279121_3_1">Debt Instrument Redemption Period Three And Thereafter [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember_lbl" xml:lang="en-US" id="id_14062202_3279121_1_1">Debt Instrument Redemption Period Three And Thereafter [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember_lbl" xml:lang="en-US" id="id_14062202_3279121_2_1">Redemption in 2021 and Thereafter [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember" xlink:to="md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodThreeMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodThreeMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodThreeMember_lbl" xml:lang="en-US" id="id_14062202_3066088_1_1">Debt Instrument, Redemption, Period Three [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodThreeMember_lbl" xml:lang="en-US" id="id_14062202_3066088_2_1">Redemption in 2022 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodThreeMember" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodThreeMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodTwoMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodTwoMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodTwoMember_lbl" xml:lang="en-US" id="id_14062202_3066089_1_1">Debt Instrument, Redemption, Period Two [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodTwoMember_lbl" xml:lang="en-US" id="id_14062202_3066089_2_1">Redemption in 2020 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodTwoMember" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodTwoMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPricePercentage" xlink:label="us-gaap_DebtInstrumentRedemptionPricePercentage"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentRedemptionPricePercentage_lbl" xml:lang="en-US" id="id_14062202_3066316_1_1">Debt Instrument, Redemption Price, Percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentRedemptionPricePercentage_lbl" xml:lang="en-US" id="id_14062202_3066316_2_1">Redemption price percentage of aggregate principal amount redeemed</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentRedemptionPricePercentage" xlink:to="us-gaap_DebtInstrumentRedemptionPricePercentage_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed" xlink:label="us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed_lbl" xml:lang="en-US" id="id_14062202_3066471_1_1">Debt Instrument, Redemption Price, Percentage of Principal Amount Redeemed</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed_lbl" xml:lang="en-US" id="id_14062202_3066471_2_1">Redemption percentage of principal amount</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed" xlink:to="us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentTable" xlink:label="us-gaap_DebtInstrumentTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DebtInstrumentTable_lbl" xml:lang="en-US" id="id_14062202_3066473_1_1">Schedule of Long-term Debt Instruments [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DebtInstrumentTable_lbl" xml:lang="en-US" id="id_14062202_3066473_2_1">Schedule of Long-term Debt Instruments [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_DebtInstrumentTable_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DeconsolidationPercentage" xlink:label="md_DeconsolidationPercentage"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DeconsolidationPercentage_lbl" xml:lang="en-US" id="id_14062202_3368386_3_1">Deconsolidation percentage.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DeconsolidationPercentage_lbl" xml:lang="en-US" id="id_14062202_3368386_1_1">Deconsolidation Percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DeconsolidationPercentage_lbl" xml:lang="en-US" id="id_14062202_3368386_2_1">Deconsolidation percentage</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DeconsolidationPercentage" xlink:to="md_DeconsolidationPercentage_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredFederalIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredFederalIncomeTaxExpenseBenefit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredFederalIncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3066810_1_1">Deferred Federal Income Tax Expense (Benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredFederalIncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3066810_2_1">Federal, Deferred</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredFederalIncomeTaxExpenseBenefit" xlink:to="us-gaap_DeferredFederalIncomeTaxExpenseBenefit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredIncomeTaxExpenseBenefit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredIncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3066824_1_1">Deferred Income Tax Expense (Benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredIncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3066824_2_1">Deferred income taxes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredIncomeTaxExpenseBenefit" xlink:to="us-gaap_DeferredIncomeTaxExpenseBenefit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredIncomeTaxLiabilities" xlink:label="us-gaap_DeferredIncomeTaxLiabilities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredIncomeTaxLiabilities_lbl" xml:lang="en-US" id="id_14062202_3066540_1_1">Deferred Tax Liabilities, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedTotalLabel" xlink:label="us-gaap_DeferredIncomeTaxLiabilities_lbl" xml:lang="en-US" id="id_14062202_3066540_19_1">Total deferred tax liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredIncomeTaxLiabilities" xlink:to="us-gaap_DeferredIncomeTaxLiabilities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3066848_1_1">Deferred State and Local Income Tax Expense (Benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3066848_2_1">State, Deferred</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" xlink:to="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsGross" xlink:label="us-gaap_DeferredTaxAssetsGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsGross_lbl" xml:lang="en-US" id="id_14062202_3067212_1_1">Deferred Tax Assets, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_DeferredTaxAssetsGross_lbl" xml:lang="en-US" id="id_14062202_3067212_6_1">Deferred tax assets before valuation allowance</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxAssetsGross" xlink:to="us-gaap_DeferredTaxAssetsGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsNet" xlink:label="us-gaap_DeferredTaxAssetsNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsNet_lbl" xml:lang="en-US" id="id_14062202_3067214_1_1">Deferred Tax Assets, Net of Valuation Allowance</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_DeferredTaxAssetsNet_lbl" xml:lang="en-US" id="id_14062202_3067214_6_1">Deferred tax assets, net of valuation allowance</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxAssetsNet" xlink:to="us-gaap_DeferredTaxAssetsNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards_lbl" xml:lang="en-US" id="id_14062202_3067095_1_1">Deferred Tax Assets, Operating Loss Carryforwards</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards_lbl" xml:lang="en-US" id="id_14062202_3067095_2_1">Net operating loss carryforward</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" xlink:to="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration_lbl" xml:lang="en-US" id="id_14062202_3067097_1_1">Deferred Tax Assets, Operating Loss Carryforwards, Not Subject to Expiration</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration_lbl" xml:lang="en-US" id="id_14062202_3067097_2_1">Operating loss carryforwards not subject to expiration</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration" xlink:to="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration_lbl" xml:lang="en-US" id="id_14062202_3067501_1_1">Deferred Tax Assets, Operating Loss Carryforwards, Subject to Expiration</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration_lbl" xml:lang="en-US" id="id_14062202_3067501_2_1">Operating loss carryforwards subject to expiration</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration" xlink:to="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOther" xlink:label="us-gaap_DeferredTaxAssetsOther"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsOther_lbl" xml:lang="en-US" id="id_14062202_3066856_1_1">Deferred Tax Assets, Other</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsOther_lbl" xml:lang="en-US" id="id_14062202_3066856_2_1">Other</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxAssetsOther" xlink:to="us-gaap_DeferredTaxAssetsOther_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment" xlink:label="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_14062202_3067502_1_1">Deferred Tax Assets, Property, Plant and Equipment</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment_lbl" xml:lang="en-US" id="id_14062202_3067502_2_1">Property and equipment</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment" xlink:to="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost_lbl" xml:lang="en-US" id="id_14062202_3067509_1_1">Deferred Tax Assets, Tax Deferred Expense, Compensation and Benefits, Share-based Compensation Cost</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost_lbl" xml:lang="en-US" id="id_14062202_3067509_2_1">Stock-based compensation</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts_lbl" xml:lang="en-US" id="id_14062202_3067511_1_1">Deferred Tax Assets, Tax Deferred Expense, Reserves and Accruals, Allowance for Doubtful Accounts</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts_lbl" xml:lang="en-US" id="id_14062202_3067511_2_1">Allowance for uncollectible accounts</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves_lbl" xml:lang="en-US" id="id_14062202_3066866_1_1">Deferred Tax Assets, Tax Deferred Expense, Reserves and Accruals, Reserves</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves_lbl" xml:lang="en-US" id="id_14062202_3066866_2_1">Reserves and accruals</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsValuationAllowance" xlink:label="us-gaap_DeferredTaxAssetsValuationAllowance"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxAssetsValuationAllowance_lbl" xml:lang="en-US" id="id_14062202_3066869_1_1">Deferred Tax Assets, Valuation Allowance</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_DeferredTaxAssetsValuationAllowance_lbl" xml:lang="en-US" id="id_14062202_3066869_14_1">Less: Valuation allowance</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxAssetsValuationAllowance" xlink:to="us-gaap_DeferredTaxAssetsValuationAllowance_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilities" xlink:label="us-gaap_DeferredTaxLiabilities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxLiabilities_lbl" xml:lang="en-US" id="id_14062202_3067518_1_1">Deferred Tax Liabilities, Net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedTotalLabel" xlink:label="us-gaap_DeferredTaxLiabilities_lbl" xml:lang="en-US" id="id_14062202_3067518_19_1">Net deferred tax liability</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxLiabilities" xlink:to="us-gaap_DeferredTaxLiabilities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesAbstract" xlink:label="us-gaap_DeferredTaxLiabilitiesAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxLiabilitiesAbstract_lbl" xml:lang="en-US" id="id_14062202_3067110_1_1">Deferred Tax Liabilities, Gross [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxLiabilitiesAbstract_lbl" xml:lang="en-US" id="id_14062202_3067110_2_1">Gross deferred tax liabilities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxLiabilitiesAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DeferredTaxLiabilitiesChangeInAccountingMethod" xlink:label="md_DeferredTaxLiabilitiesChangeInAccountingMethod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DeferredTaxLiabilitiesChangeInAccountingMethod_lbl" xml:lang="en-US" id="id_14062202_3197063_3_1">Deferred tax liabilities change in accounting method.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DeferredTaxLiabilitiesChangeInAccountingMethod_lbl" xml:lang="en-US" id="id_14062202_3197063_1_1">Deferred Tax Liabilities Change in Accounting Method</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DeferredTaxLiabilitiesChangeInAccountingMethod_lbl" xml:lang="en-US" id="id_14062202_3197063_2_1">Accounting method changes</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="md_DeferredTaxLiabilitiesChangeInAccountingMethod_lbl" xml:lang="en-US" id="id_14062202_3197063_14_1">Accounting method changes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DeferredTaxLiabilitiesChangeInAccountingMethod" xlink:to="md_DeferredTaxLiabilitiesChangeInAccountingMethod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" xlink:label="us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals_lbl" xml:lang="en-US" id="id_14062202_3067521_1_1">Deferred Tax Liabilities, Deferred Expense, Reserves and Accruals</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals_lbl" xml:lang="en-US" id="id_14062202_3067521_14_1">Accrual to cash adjustment</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" xlink:to="us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" xlink:label="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets_lbl" xml:lang="en-US" id="id_14062202_3066877_1_1">Deferred Tax Liabilities, Intangible Assets</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets_lbl" xml:lang="en-US" id="id_14062202_3066877_14_1">Amortization</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" xlink:to="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesNoncurrent" xlink:label="us-gaap_DeferredTaxLiabilitiesNoncurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxLiabilitiesNoncurrent_lbl" xml:lang="en-US" id="id_14062202_3067115_1_1">Deferred Tax Liabilities, Net, Noncurrent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DeferredTaxLiabilitiesNoncurrent_lbl" xml:lang="en-US" id="id_14062202_3067115_2_1">Deferred income taxes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxLiabilitiesNoncurrent" xlink:to="us-gaap_DeferredTaxLiabilitiesNoncurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesOther" xlink:label="us-gaap_DeferredTaxLiabilitiesOther"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DeferredTaxLiabilitiesOther_lbl" xml:lang="en-US" id="id_14062202_3067241_1_1">Deferred Tax Liabilities, Other</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_DeferredTaxLiabilitiesOther_lbl" xml:lang="en-US" id="id_14062202_3067241_14_1">Other</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DeferredTaxLiabilitiesOther" xlink:to="us-gaap_DeferredTaxLiabilitiesOther_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DefinedContributionPlanCostRecognized" xlink:label="us-gaap_DefinedContributionPlanCostRecognized"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DefinedContributionPlanCostRecognized_lbl" xml:lang="en-US" id="id_14062202_3067845_1_1">Defined Contribution Plan, Cost</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DefinedContributionPlanCostRecognized_lbl" xml:lang="en-US" id="id_14062202_3067845_2_1">Expense of retirement plans related to the 401(k) Plans</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DefinedContributionPlanCostRecognized" xlink:to="us-gaap_DefinedContributionPlanCostRecognized_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Depreciation" xlink:label="us-gaap_Depreciation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_Depreciation_lbl" xml:lang="en-US" id="id_14062202_3067617_1_1">Depreciation</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_Depreciation_lbl" xml:lang="en-US" id="id_14062202_3067617_2_1">Recorded depreciation expense</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_Depreciation" xlink:to="us-gaap_Depreciation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DepreciationDepletionAndAmortization" xlink:label="us-gaap_DepreciationDepletionAndAmortization"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DepreciationDepletionAndAmortization_lbl" xml:lang="en-US" id="id_14062202_3067619_1_1">Depreciation, Depletion and Amortization</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DepreciationDepletionAndAmortization_lbl" xml:lang="en-US" id="id_14062202_3067619_2_1">Depreciation and amortization</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DepreciationDepletionAndAmortization" xlink:to="us-gaap_DepreciationDepletionAndAmortization_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisaggregationOfRevenueAbstract" xlink:label="us-gaap_DisaggregationOfRevenueAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DisaggregationOfRevenueAbstract_lbl" xml:lang="en-US" id="id_14062202_3068010_1_1">Disaggregation of Revenue [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DisaggregationOfRevenueAbstract_lbl" xml:lang="en-US" id="id_14062202_3068010_2_1">Disaggregation of Revenue [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DisaggregationOfRevenueAbstract" xlink:to="us-gaap_DisaggregationOfRevenueAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisaggregationOfRevenueTableTextBlock" xlink:label="us-gaap_DisaggregationOfRevenueTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DisaggregationOfRevenueTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3068121_1_1">Disaggregation of Revenue [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DisaggregationOfRevenueTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3068121_2_1">Schedule of Net Revenue</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DisaggregationOfRevenueTableTextBlock" xlink:to="us-gaap_DisaggregationOfRevenueTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract_lbl" xml:lang="en-US" id="id_14062202_3068434_1_1">Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract_lbl" xml:lang="en-US" id="id_14062202_3068434_2_1">Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock_lbl" xml:lang="en-US" id="id_14062202_3067742_1_1">Disclosure of Compensation Related Costs, Share-based Payments [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock_lbl" xml:lang="en-US" id="id_14062202_3067742_2_1">Stock Incentive Plans and Stock Purchase Plans</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" xlink:to="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DocumentAndEntityInformationAbstract" xlink:label="md_DocumentAndEntityInformationAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_DocumentAndEntityInformationAbstract_lbl" xml:lang="en-US" id="id_14062202_3085999_3_1">Document And Entity Information.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_DocumentAndEntityInformationAbstract_lbl" xml:lang="en-US" id="id_14062202_3085999_1_1">Document And Entity Information [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_DocumentAndEntityInformationAbstract_lbl" xml:lang="en-US" id="id_14062202_3085999_2_1">Document And Entity Information [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="md_DocumentAndEntityInformationAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentFiscalPeriodFocus" xlink:label="dei_DocumentFiscalPeriodFocus"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_DocumentFiscalPeriodFocus_lbl" xml:lang="en-US" id="id_14062202_3067826_1_1">Document Fiscal Period Focus</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_DocumentFiscalPeriodFocus_lbl" xml:lang="en-US" id="id_14062202_3067826_2_1">Document Fiscal Period Focus</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_DocumentFiscalPeriodFocus" xlink:to="dei_DocumentFiscalPeriodFocus_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentFiscalYearFocus" xlink:label="dei_DocumentFiscalYearFocus"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_DocumentFiscalYearFocus_lbl" xml:lang="en-US" id="id_14062202_3067827_1_1">Document Fiscal Year Focus</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_DocumentFiscalYearFocus_lbl" xml:lang="en-US" id="id_14062202_3067827_2_1">Document Fiscal Year Focus</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_DocumentFiscalYearFocus" xlink:to="dei_DocumentFiscalYearFocus_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentPeriodEndDate" xlink:label="dei_DocumentPeriodEndDate"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_DocumentPeriodEndDate_lbl" xml:lang="en-US" id="id_14062202_3069166_1_1">Document Period End Date</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_DocumentPeriodEndDate_lbl" xml:lang="en-US" id="id_14062202_3069166_2_1">Document Period End Date</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_DocumentPeriodEndDate" xlink:to="dei_DocumentPeriodEndDate_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentType" xlink:label="dei_DocumentType"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_DocumentType_lbl" xml:lang="en-US" id="id_14062202_3067831_1_1">Document Type</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_DocumentType_lbl" xml:lang="en-US" id="id_14062202_3067831_2_1">Document Type</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_DocumentType" xlink:to="dei_DocumentType_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarliestTaxYearMember" xlink:label="us-gaap_EarliestTaxYearMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarliestTaxYearMember_lbl" xml:lang="en-US" id="id_14062202_3068238_1_1">Earliest Tax Year [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarliestTaxYearMember_lbl" xml:lang="en-US" id="id_14062202_3068238_2_1">Earliest Tax Year [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EarliestTaxYearMember" xlink:to="us-gaap_EarliestTaxYearMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:label="us-gaap_EarningsPerShareAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerShareAbstract_lbl" xml:lang="en-US" id="id_14062202_3069192_1_1">Earnings Per Share [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerShareAbstract_lbl" xml:lang="en-US" id="id_14062202_3069192_2_1">Net income attributable to MEDNAX, Inc.:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_EarningsPerShareAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareBasic" xlink:label="us-gaap_EarningsPerShareBasic"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerShareBasic_lbl" xml:lang="en-US" id="id_14062202_3069193_1_1">Earnings Per Share, Basic</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerShareBasic_lbl" xml:lang="en-US" id="id_14062202_3069193_2_1">Earnings per share, Basic</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EarningsPerShareBasic" xlink:to="us-gaap_EarningsPerShareBasic_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract" xlink:label="us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract_lbl" xml:lang="en-US" id="id_14062202_3069194_1_1">Earnings Per Share, Basic, Other Disclosures [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract_lbl" xml:lang="en-US" id="id_14062202_3069194_2_1">Weighted average common shares:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract" xlink:to="us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareDiluted" xlink:label="us-gaap_EarningsPerShareDiluted"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerShareDiluted_lbl" xml:lang="en-US" id="id_14062202_3068505_1_1">Earnings Per Share, Diluted</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerShareDiluted_lbl" xml:lang="en-US" id="id_14062202_3068505_2_1">Earnings per share, Diluted</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EarningsPerShareDiluted" xlink:to="us-gaap_EarningsPerShareDiluted_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerSharePolicyTextBlock" xlink:label="us-gaap_EarningsPerSharePolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerSharePolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3068509_1_1">Earnings Per Share, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerSharePolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3068509_2_1">Net Income Per Common Share</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EarningsPerSharePolicyTextBlock" xlink:to="us-gaap_EarningsPerSharePolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareTextBlock" xlink:label="us-gaap_EarningsPerShareTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EarningsPerShareTextBlock_lbl" xml:lang="en-US" id="id_14062202_3068250_1_1">Earnings Per Share [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EarningsPerShareTextBlock_lbl" xml:lang="en-US" id="id_14062202_3068250_2_1">Common and Common Equivalent Shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EarningsPerShareTextBlock" xlink:to="us-gaap_EarningsPerShareTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:label="us-gaap_EffectiveIncomeTaxRateContinuingOperations"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EffectiveIncomeTaxRateContinuingOperations_lbl" xml:lang="en-US" id="id_14062202_3068259_1_1">Effective Income Tax Rate Reconciliation, Percent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EffectiveIncomeTaxRateContinuingOperations_lbl" xml:lang="en-US" id="id_14062202_3068259_2_1">Effective tax rate</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_EffectiveIncomeTaxRateContinuingOperations_lbl" xml:lang="en-US" id="id_14062202_3068259_6_1">Income tax provision</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:to="us-gaap_EffectiveIncomeTaxRateContinuingOperations_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate_lbl" xml:lang="en-US" id="id_14062202_3068518_1_1">Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate_lbl" xml:lang="en-US" id="id_14062202_3068518_2_1">Tax at statutory rate</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance_lbl" xml:lang="en-US" id="id_14062202_3068519_1_1">Effective Income Tax Rate Reconciliation, Change in Deferred Tax Assets Valuation Allowance, Percent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance_lbl" xml:lang="en-US" id="id_14062202_3068519_2_1">Change in valuation allowance</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate_lbl" xml:lang="en-US" id="id_14062202_3069205_1_1">Effective Income Tax Rate Reconciliation, Change in Enacted Tax Rate, Percent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate_lbl" xml:lang="en-US" id="id_14062202_3069205_2_1">Change in tax law</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense_lbl" xml:lang="en-US" id="id_14062202_3069210_1_1">Effective Income Tax Rate Reconciliation, Nondeductible Expense, Percent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense_lbl" xml:lang="en-US" id="id_14062202_3069210_2_1">Non-deductible expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments_lbl" xml:lang="en-US" id="id_14062202_3069215_1_1">Effective Income Tax Rate Reconciliation, Other Adjustments, Percent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments_lbl" xml:lang="en-US" id="id_14062202_3069215_2_1">Change in accrual estimates relating to uncertain tax positions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent_lbl" xml:lang="en-US" id="id_14062202_3068525_1_1">Effective Income Tax Rate Reconciliation,Other Reconciling Items, Percent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent_lbl" xml:lang="en-US" id="id_14062202_3068525_2_1">Other, net</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes_lbl" xml:lang="en-US" id="id_14062202_3068785_1_1">Effective Income Tax Rate Reconciliation, State and Local Income Taxes, Percent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes_lbl" xml:lang="en-US" id="id_14062202_3068785_2_1">State income tax, net of federal benefit</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1_lbl" xml:lang="en-US" id="id_14062202_3068967_1_1">Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1_lbl" xml:lang="en-US" id="id_14062202_3068967_2_1">Unrecognized compensation expense related to non-vested restricted stock, weighted-average period in years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions_lbl" xml:lang="en-US" id="id_14062202_3068817_1_1">Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Share-based Awards Other than Options</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions_lbl" xml:lang="en-US" id="id_14062202_3068817_2_1">Unrecognized compensation expense related to non-vested restricted shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockOptionMember" xlink:label="us-gaap_EmployeeStockOptionMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EmployeeStockOptionMember_lbl" xml:lang="en-US" id="id_14062202_3069261_1_1">Employee Stock Option [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EmployeeStockOptionMember_lbl" xml:lang="en-US" id="id_14062202_3069261_2_1">Stock Option [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EmployeeStockOptionMember" xlink:to="us-gaap_EmployeeStockOptionMember_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityCentralIndexKey" xlink:label="dei_EntityCentralIndexKey"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntityCentralIndexKey_lbl" xml:lang="en-US" id="id_14062202_3068584_1_1">Entity Central Index Key</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntityCentralIndexKey_lbl" xml:lang="en-US" id="id_14062202_3068584_2_1">Entity Central Index Key</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntityCentralIndexKey" xlink:to="dei_EntityCentralIndexKey_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityCommonStockSharesOutstanding" xlink:label="dei_EntityCommonStockSharesOutstanding"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntityCommonStockSharesOutstanding_lbl" xml:lang="en-US" id="id_14062202_3069289_1_1">Entity Common Stock, Shares Outstanding</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntityCommonStockSharesOutstanding_lbl" xml:lang="en-US" id="id_14062202_3069289_2_1">Entity Common Stock, Shares Outstanding</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntityCommonStockSharesOutstanding" xlink:to="dei_EntityCommonStockSharesOutstanding_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityCurrentReportingStatus" xlink:label="dei_EntityCurrentReportingStatus"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntityCurrentReportingStatus_lbl" xml:lang="en-US" id="id_14062202_3069292_1_1">Entity Current Reporting Status</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntityCurrentReportingStatus_lbl" xml:lang="en-US" id="id_14062202_3069292_2_1">Entity Current Reporting Status</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntityCurrentReportingStatus" xlink:to="dei_EntityCurrentReportingStatus_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityEmergingGrowthCompany" xlink:label="dei_EntityEmergingGrowthCompany"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntityEmergingGrowthCompany_lbl" xml:lang="en-US" id="id_14062202_3069294_1_1">Entity Emerging Growth Company</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntityEmergingGrowthCompany_lbl" xml:lang="en-US" id="id_14062202_3069294_2_1">Entity Emerging Company</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntityEmergingGrowthCompany" xlink:to="dei_EntityEmergingGrowthCompany_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityExTransitionPeriod" xlink:label="dei_EntityExTransitionPeriod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntityExTransitionPeriod_lbl" xml:lang="en-US" id="id_14062202_3069295_1_1">Entity Ex Transition Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntityExTransitionPeriod_lbl" xml:lang="en-US" id="id_14062202_3069295_2_1">Entity Ex Transition Period</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntityExTransitionPeriod" xlink:to="dei_EntityExTransitionPeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityFilerCategory" xlink:label="dei_EntityFilerCategory"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntityFilerCategory_lbl" xml:lang="en-US" id="id_14062202_3069296_1_1">Entity Filer Category</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntityFilerCategory_lbl" xml:lang="en-US" id="id_14062202_3069296_2_1">Entity Filer Category</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntityFilerCategory" xlink:to="dei_EntityFilerCategory_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityPublicFloat" xlink:label="dei_EntityPublicFloat"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntityPublicFloat_lbl" xml:lang="en-US" id="id_14062202_3069004_1_1">Entity Public Float</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntityPublicFloat_lbl" xml:lang="en-US" id="id_14062202_3069004_2_1">Entity Public Float</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntityPublicFloat" xlink:to="dei_EntityPublicFloat_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityRegistrantName" xlink:label="dei_EntityRegistrantName"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntityRegistrantName_lbl" xml:lang="en-US" id="id_14062202_3069005_1_1">Entity Registrant Name</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntityRegistrantName_lbl" xml:lang="en-US" id="id_14062202_3069005_2_1">Entity Registrant Name</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntityRegistrantName" xlink:to="dei_EntityRegistrantName_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityShellCompany" xlink:label="dei_EntityShellCompany"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntityShellCompany_lbl" xml:lang="en-US" id="id_14062202_3069007_1_1">Entity Shell Company</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntityShellCompany_lbl" xml:lang="en-US" id="id_14062202_3069007_2_1">Entity Shell Company</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntityShellCompany" xlink:to="dei_EntityShellCompany_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntitySmallBusiness" xlink:label="dei_EntitySmallBusiness"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntitySmallBusiness_lbl" xml:lang="en-US" id="id_14062202_3069008_1_1">Entity Small Business</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntitySmallBusiness_lbl" xml:lang="en-US" id="id_14062202_3069008_2_1">Entity Small Business</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntitySmallBusiness" xlink:to="dei_EntitySmallBusiness_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityVoluntaryFilers" xlink:label="dei_EntityVoluntaryFilers"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntityVoluntaryFilers_lbl" xml:lang="en-US" id="id_14062202_3069010_1_1">Entity Voluntary Filers</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntityVoluntaryFilers_lbl" xml:lang="en-US" id="id_14062202_3069010_2_1">Entity Voluntary Filers</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntityVoluntaryFilers" xlink:to="dei_EntityVoluntaryFilers_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityWellKnownSeasonedIssuer" xlink:label="dei_EntityWellKnownSeasonedIssuer"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_EntityWellKnownSeasonedIssuer_lbl" xml:lang="en-US" id="id_14062202_3068598_1_1">Entity Well-known Seasoned Issuer</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_EntityWellKnownSeasonedIssuer_lbl" xml:lang="en-US" id="id_14062202_3068598_2_1">Entity Well-known Seasoned Issuer</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_EntityWellKnownSeasonedIssuer" xlink:to="dei_EntityWellKnownSeasonedIssuer_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquipmentMember" xlink:label="us-gaap_EquipmentMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EquipmentMember_lbl" xml:lang="en-US" id="id_14062202_3068864_1_1">Equipment [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EquipmentMember_lbl" xml:lang="en-US" id="id_14062202_3068864_2_1">Medical Equipment [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EquipmentMember" xlink:to="us-gaap_EquipmentMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityAbstract" xlink:label="us-gaap_EquityAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EquityAbstract_lbl" xml:lang="en-US" id="id_14062202_3068865_1_1">Equity [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EquityAbstract_lbl" xml:lang="en-US" id="id_14062202_3068865_2_1">Equity [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EquityAbstract" xlink:to="us-gaap_EquityAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:label="us-gaap_EquityComponentDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EquityComponentDomain_lbl" xml:lang="en-US" id="id_14062202_3069019_1_1">Equity Component [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EquityComponentDomain_lbl" xml:lang="en-US" id="id_14062202_3069019_2_1">Equity Component [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_EquityComponentDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_EquityMethodInvesteeNameDomain" xlink:label="srt_EquityMethodInvesteeNameDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="srt_EquityMethodInvesteeNameDomain_lbl" xml:lang="en-US" id="id_14062202_3069327_1_1">Investment, Name [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="srt_EquityMethodInvesteeNameDomain_lbl" xml:lang="en-US" id="id_14062202_3069327_2_1">Investment, Name [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="srt_EquityMethodInvesteeNameDomain" xlink:to="srt_EquityMethodInvesteeNameDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityMethodInvestmentOwnershipPercentage" xlink:label="us-gaap_EquityMethodInvestmentOwnershipPercentage"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EquityMethodInvestmentOwnershipPercentage_lbl" xml:lang="en-US" id="id_14062202_3069330_1_1">Equity Method Investment, Ownership Percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EquityMethodInvestmentOwnershipPercentage_lbl" xml:lang="en-US" id="id_14062202_3069330_2_1">Equity method ownership percentage in joint venture</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_EquityMethodInvestmentOwnershipPercentage_lbl" xml:lang="en-US" id="id_14062202_3069330_12_1">Sale of equity method investments</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EquityMethodInvestmentOwnershipPercentage" xlink:to="us-gaap_EquityMethodInvestmentOwnershipPercentage_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EstimateOfFairValueFairValueDisclosureMember" xlink:label="us-gaap_EstimateOfFairValueFairValueDisclosureMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_EstimateOfFairValueFairValueDisclosureMember_lbl" xml:lang="en-US" id="id_14062202_3068644_1_1">Estimate of Fair Value Measurement [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_EstimateOfFairValueFairValueDisclosureMember_lbl" xml:lang="en-US" id="id_14062202_3068644_2_1">Estimate of Fair Value Measurement [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_EstimateOfFairValueFairValueDisclosureMember" xlink:to="us-gaap_EstimateOfFairValueFairValueDisclosureMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities" xlink:label="us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities_lbl" xml:lang="en-US" id="id_14062202_3068914_1_1">Excess Tax Benefit from Share-based Compensation, Financing Activities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities_lbl" xml:lang="en-US" id="id_14062202_3068914_2_1">Excess tax benefit from exercises of stock options and vesting of restricted stock</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities" xlink:to="us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:label="us-gaap_FairValueByFairValueHierarchyLevelAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FairValueByFairValueHierarchyLevelAxis_lbl" xml:lang="en-US" id="id_14062202_3068684_1_1">Fair Value Hierarchy and NAV [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FairValueByFairValueHierarchyLevelAxis_lbl" xml:lang="en-US" id="id_14062202_3068684_2_1">Fair Value Hierarchy and NAV [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:to="us-gaap_FairValueByFairValueHierarchyLevelAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueByMeasurementBasisAxis" xlink:label="us-gaap_FairValueByMeasurementBasisAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FairValueByMeasurementBasisAxis_lbl" xml:lang="en-US" id="id_14062202_3070058_1_1">Measurement Basis [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FairValueByMeasurementBasisAxis_lbl" xml:lang="en-US" id="id_14062202_3070058_2_1">Measurement Basis [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FairValueByMeasurementBasisAxis" xlink:to="us-gaap_FairValueByMeasurementBasisAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueDisclosureItemAmountsDomain" xlink:label="us-gaap_FairValueDisclosureItemAmountsDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FairValueDisclosureItemAmountsDomain_lbl" xml:lang="en-US" id="id_14062202_3068697_1_1">Fair Value Measurement [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FairValueDisclosureItemAmountsDomain_lbl" xml:lang="en-US" id="id_14062202_3068697_2_1">Fair Value Measurement [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FairValueDisclosureItemAmountsDomain" xlink:to="us-gaap_FairValueDisclosureItemAmountsDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueInputsLevel2Member" xlink:label="us-gaap_FairValueInputsLevel2Member"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FairValueInputsLevel2Member_lbl" xml:lang="en-US" id="id_14062202_3070091_1_1">Fair Value, Inputs, Level 2 [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FairValueInputsLevel2Member_lbl" xml:lang="en-US" id="id_14062202_3070091_2_1">Level 2 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FairValueInputsLevel2Member" xlink:to="us-gaap_FairValueInputsLevel2Member_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:label="us-gaap_FairValueMeasurementsFairValueHierarchyDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FairValueMeasurementsFairValueHierarchyDomain_lbl" xml:lang="en-US" id="id_14062202_3069403_1_1">Fair Value Hierarchy and NAV [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FairValueMeasurementsFairValueHierarchyDomain_lbl" xml:lang="en-US" id="id_14062202_3069403_2_1">Fair Value Hierarchy and NAV [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:to="us-gaap_FairValueMeasurementsFairValueHierarchyDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueOfFinancialInstrumentsPolicy" xlink:label="us-gaap_FairValueOfFinancialInstrumentsPolicy"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FairValueOfFinancialInstrumentsPolicy_lbl" xml:lang="en-US" id="id_14062202_3069419_1_1">Fair Value of Financial Instruments, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FairValueOfFinancialInstrumentsPolicy_lbl" xml:lang="en-US" id="id_14062202_3069419_2_1">Fair Value Measurements</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FairValueOfFinancialInstrumentsPolicy" xlink:to="us-gaap_FairValueOfFinancialInstrumentsPolicy_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FederalFundsEffectiveSwapRateMember" xlink:label="us-gaap_FederalFundsEffectiveSwapRateMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FederalFundsEffectiveSwapRateMember_lbl" xml:lang="en-US" id="id_14062202_3069706_1_1">Federal Funds Effective Swap Rate [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FederalFundsEffectiveSwapRateMember_lbl" xml:lang="en-US" id="id_14062202_3069706_2_1">Federal Funds Rate [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FederalFundsEffectiveSwapRateMember" xlink:to="us-gaap_FederalFundsEffectiveSwapRateMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations" xlink:label="us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations_lbl" xml:lang="en-US" id="id_14062202_3069488_1_1">Federal Income Tax Expense (Benefit), Continuing Operations</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations_lbl" xml:lang="en-US" id="id_14062202_3069488_6_1">Federal income tax provision, Total</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations" xlink:to="us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization_lbl" xml:lang="en-US" id="id_14062202_3070486_1_1">Finite-Lived Intangible Assets, Accumulated Amortization</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization_lbl" xml:lang="en-US" id="id_14062202_3070486_14_1">Accumulated Amortization</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FinitelivedIntangibleAssetsAcquired1" xlink:label="us-gaap_FinitelivedIntangibleAssetsAcquired1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FinitelivedIntangibleAssetsAcquired1_lbl" xml:lang="en-US" id="id_14062202_3070938_1_1">Finite-lived Intangible Assets Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FinitelivedIntangibleAssetsAcquired1_lbl" xml:lang="en-US" id="id_14062202_3070938_2_1">Intangible assets related to acquisitions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FinitelivedIntangibleAssetsAcquired1" xlink:to="us-gaap_FinitelivedIntangibleAssetsAcquired1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths_lbl" xml:lang="en-US" id="id_14062202_3070487_1_1">Finite-Lived Intangible Assets, Amortization Expense, Next Twelve Months</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths_lbl" xml:lang="en-US" id="id_14062202_3070487_2_1">Amortization expense for existing other intangible assets, 2019</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3070942_1_1">Finite-lived Intangible Assets Amortization Expense [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3070942_2_1">Amortization Expenses for Existing Intangible Assets for the Next Five Years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive_lbl" xml:lang="en-US" id="id_14062202_3070667_1_1">Finite-Lived Intangible Assets, Amortization Expense, Year Five</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive_lbl" xml:lang="en-US" id="id_14062202_3070667_2_1">Amortization expense for existing other intangible assets, 2023</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour_lbl" xml:lang="en-US" id="id_14062202_3070489_1_1">Finite-Lived Intangible Assets, Amortization Expense, Year Four</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour_lbl" xml:lang="en-US" id="id_14062202_3070489_2_1">Amortization expense for existing other intangible assets, 2022</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree_lbl" xml:lang="en-US" id="id_14062202_3070668_1_1">Finite-Lived Intangible Assets, Amortization Expense, Year Three</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree_lbl" xml:lang="en-US" id="id_14062202_3070668_2_1">Amortization expense for existing other intangible assets, 2021</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo_lbl" xml:lang="en-US" id="id_14062202_3070669_1_1">Finite-Lived Intangible Assets, Amortization Expense, Year Two</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo_lbl" xml:lang="en-US" id="id_14062202_3070669_2_1">Amortization expense for existing other intangible assets, 2020</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis_lbl" xml:lang="en-US" id="id_14062202_3070943_1_1">Finite-Lived Intangible Assets by Major Class [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis_lbl" xml:lang="en-US" id="id_14062202_3070943_2_1">Finite-Lived Intangible Assets by Major Class [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsGross" xlink:label="us-gaap_FiniteLivedIntangibleAssetsGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsGross_lbl" xml:lang="en-US" id="id_14062202_3070672_1_1">Finite-Lived Intangible Assets, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsGross_lbl" xml:lang="en-US" id="id_14062202_3070672_2_1">Gross Carrying Value</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsGross" xlink:to="us-gaap_FiniteLivedIntangibleAssetsGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:label="us-gaap_FiniteLivedIntangibleAssetsLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsLineItems_lbl" xml:lang="en-US" id="id_14062202_3070944_1_1">Finite-Lived Intangible Assets [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsLineItems_lbl" xml:lang="en-US" id="id_14062202_3070944_2_1">Finite-Lived Intangible Assets [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_lbl" xml:lang="en-US" id="id_14062202_3070493_1_1">Finite-Lived Intangible Assets, Major Class Name [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_lbl" xml:lang="en-US" id="id_14062202_3070493_2_1">Finite-Lived Intangible Assets, Major Class Name [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain_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_14062202_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_14062202_3070675_2_1">Intangible assets, net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetsNet_lbl" xml:lang="en-US" id="id_14062202_3070675_6_1">Net Carrying Value</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetsNet" xlink:to="us-gaap_FiniteLivedIntangibleAssetsNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife_lbl" xml:lang="en-US" id="id_14062202_3070231_1_1">Finite-Lived Intangible Asset, Useful Life</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife_lbl" xml:lang="en-US" id="id_14062202_3070231_2_1">Intangible assets finite lives</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:to="us-gaap_FiniteLivedIntangibleAssetUsefulLife_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.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_14062202_3297729_3_1">Five point two five percent senior unsecured notes due two thousand twenty three.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember_lbl" xml:lang="en-US" id="id_14062202_3297729_1_1">Five Point Two Five Percent Senior Unsecured Notes Due Two Thousand Twenty Three [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember_lbl" xml:lang="en-US" id="id_14062202_3297729_2_1">5.25% Senior Unsecured Notes Due 2023 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:to="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FixturesAndEquipmentGross" xlink:label="us-gaap_FixturesAndEquipmentGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FixturesAndEquipmentGross_lbl" xml:lang="en-US" id="id_14062202_3070694_1_1">Fixtures and Equipment, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FixturesAndEquipmentGross_lbl" xml:lang="en-US" id="id_14062202_3070694_2_1">Equipment and other</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FixturesAndEquipmentGross" xlink:to="us-gaap_FixturesAndEquipmentGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FurnitureAndFixturesMember" xlink:label="us-gaap_FurnitureAndFixturesMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FurnitureAndFixturesMember_lbl" xml:lang="en-US" id="id_14062202_3070568_1_1">Furniture and Fixtures [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FurnitureAndFixturesMember_lbl" xml:lang="en-US" id="id_14062202_3070568_2_1">Furniture [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FurnitureAndFixturesMember" xlink:to="us-gaap_FurnitureAndFixturesMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_14062202_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_14062202_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_GoodwillAcquiredDuringPeriod" xlink:label="us-gaap_GoodwillAcquiredDuringPeriod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GoodwillAcquiredDuringPeriod_lbl" xml:lang="en-US" id="id_14062202_3070823_1_1">Goodwill, Acquired During Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GoodwillAcquiredDuringPeriod_lbl" xml:lang="en-US" id="id_14062202_3070823_2_1">Goodwill</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GoodwillAcquiredDuringPeriod" xlink:to="us-gaap_GoodwillAcquiredDuringPeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3070650_1_1">Goodwill and Intangible Assets Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3070650_2_1">Goodwill and Intangible Assets Disclosure [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3070651_1_1">Goodwill and Intangible Assets Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3070651_2_1">Goodwill and Intangible Assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" xlink:to="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock" xlink:label="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3070824_1_1">Goodwill and Intangible Assets, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3070824_2_1">Goodwill and Other Intangible Assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock" xlink:to="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:label="md_GoodwillAndOtherIntangibleAssetsLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_GoodwillAndOtherIntangibleAssetsLineItems_lbl" xml:lang="en-US" id="id_14062202_3089328_3_1">Goodwill And Other Intangible Assets [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_GoodwillAndOtherIntangibleAssetsLineItems_lbl" xml:lang="en-US" id="id_14062202_3089328_1_1">Goodwill And Other Intangible Assets [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_GoodwillAndOtherIntangibleAssetsLineItems_lbl" xml:lang="en-US" id="id_14062202_3089328_2_1">Goodwill And Other Intangible Assets [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="md_GoodwillAndOtherIntangibleAssetsLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillPeriodIncreaseDecrease" xlink:label="us-gaap_GoodwillPeriodIncreaseDecrease"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GoodwillPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_14062202_3070659_1_1">Goodwill, Period Increase (Decrease)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GoodwillPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_14062202_3070659_2_1">Change in goodwill carrying amount</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GoodwillPeriodIncreaseDecrease" xlink:to="us-gaap_GoodwillPeriodIncreaseDecrease_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_GovernmentContractsConcentrationRiskMember" xlink:label="us-gaap_GovernmentContractsConcentrationRiskMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GovernmentContractsConcentrationRiskMember_lbl" xml:lang="en-US" id="id_14062202_3071754_1_1">Government Contracts Concentration Risk [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GovernmentContractsConcentrationRiskMember_lbl" xml:lang="en-US" id="id_14062202_3071754_2_1">Government Contracts Concentration Risk [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GovernmentContractsConcentrationRiskMember" xlink:to="us-gaap_GovernmentContractsConcentrationRiskMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:label="us-gaap_HealthCareOrganizationRevenueSourcesDomain"/>
    <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_14062202_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_14062202_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_HealthCareOrganizationsAbstract" xlink:label="us-gaap_HealthCareOrganizationsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HealthCareOrganizationsAbstract_lbl" xml:lang="en-US" id="id_14062202_3071349_1_1">Health Care Organizations [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HealthCareOrganizationsAbstract_lbl" xml:lang="en-US" id="id_14062202_3071349_2_1">Health Care Organizations [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HealthCareOrganizationsAbstract" xlink:to="us-gaap_HealthCareOrganizationsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_3071544_2_1">Due after five years through six years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount" xlink:to="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_3071813_2_1">Due after one year through five years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount" xlink:to="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HeldToMaturitySecuritiesNoncurrent" xlink:label="us-gaap_HeldToMaturitySecuritiesNoncurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HeldToMaturitySecuritiesNoncurrent_lbl" xml:lang="en-US" id="id_14062202_3071828_1_1">Debt Securities, Held-to-maturity, Noncurrent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HeldToMaturitySecuritiesNoncurrent_lbl" xml:lang="en-US" id="id_14062202_3071828_2_1">Investments</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_HeldToMaturitySecuritiesNoncurrent_lbl" xml:lang="en-US" id="id_14062202_3071828_6_1">Total</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_HeldToMaturitySecuritiesNoncurrent_lbl" xml:lang="en-US" id="id_14062202_3071828_12_1">Long-Term</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HeldToMaturitySecuritiesNoncurrent" xlink:to="us-gaap_HeldToMaturitySecuritiesNoncurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HeldToMaturitySecuritiesTextBlock" xlink:label="us-gaap_HeldToMaturitySecuritiesTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HeldToMaturitySecuritiesTextBlock_lbl" xml:lang="en-US" id="id_14062202_3071562_1_1">Debt Securities, Held-to-maturity [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HeldToMaturitySecuritiesTextBlock_lbl" xml:lang="en-US" id="id_14062202_3071562_2_1">Schedule of Investments</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HeldToMaturitySecuritiesTextBlock" xlink:to="us-gaap_HeldToMaturitySecuritiesTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_HospitalsContractsMember" xlink:label="md_HospitalsContractsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_HospitalsContractsMember_lbl" xml:lang="en-US" id="id_14062202_3296576_3_1">Hospitals Contracts [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_HospitalsContractsMember_lbl" xml:lang="en-US" id="id_14062202_3296576_1_1">Hospitals Contracts [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_HospitalsContractsMember_lbl" xml:lang="en-US" id="id_14062202_3296576_2_1">Hospital contract administrative fees</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_HospitalsContractsMember" xlink:to="md_HospitalsContractsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock" xlink:label="us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3071619_1_1">Impairment or Disposal of Long-Lived Assets, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3071619_2_1">Long-Lived Assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock" xlink:to="us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest_lbl" xml:lang="en-US" id="id_14062202_3071165_1_1">Income (Loss) from Continuing Operations before Income Taxes, Noncontrolling Interest</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest_lbl" xml:lang="en-US" id="id_14062202_3071165_2_1">Income before income taxes</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest_lbl" xml:lang="en-US" id="id_14062202_3071165_6_1">Income before income taxes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:to="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeLossFromEquityMethodInvestments" xlink:label="us-gaap_IncomeLossFromEquityMethodInvestments"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeLossFromEquityMethodInvestments_lbl" xml:lang="en-US" id="id_14062202_3071177_1_1">Income (Loss) from Equity Method Investments</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeLossFromEquityMethodInvestments_lbl" xml:lang="en-US" id="id_14062202_3071177_2_1">Equity (loss) in earnings of unconsolidated affiliate</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_IncomeLossFromEquityMethodInvestments_lbl" xml:lang="en-US" id="id_14062202_3071177_12_1">Equity in earnings of unconsolidated affiliates</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeLossFromEquityMethodInvestments" xlink:to="us-gaap_IncomeLossFromEquityMethodInvestments_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeStatementAbstract" xlink:label="us-gaap_IncomeStatementAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeStatementAbstract_lbl" xml:lang="en-US" id="id_14062202_3071185_1_1">Income Statement [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeStatementAbstract_lbl" xml:lang="en-US" id="id_14062202_3071185_2_1">Income Statement [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_IncomeStatementAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="us-gaap_IncomeTaxDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeTaxDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3071190_1_1">Income Tax Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3071190_2_1">Income Tax Disclosure [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_IncomeTaxDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureTextBlock" xlink:label="us-gaap_IncomeTaxDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeTaxDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3071466_1_1">Income Tax Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3071466_2_1">Income Taxes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeTaxDisclosureTextBlock" xlink:to="us-gaap_IncomeTaxDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxesPaidNet" xlink:label="us-gaap_IncomeTaxesPaidNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeTaxesPaidNet_lbl" xml:lang="en-US" id="id_14062202_3071470_1_1">Income Taxes Paid, Net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxesPaidNet_lbl" xml:lang="en-US" id="id_14062202_3071470_2_1">Income taxes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeTaxesPaidNet" xlink:to="us-gaap_IncomeTaxesPaidNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued" xlink:label="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued_lbl" xml:lang="en-US" id="id_14062202_3071658_1_1">Income Tax Examination, Penalties and Interest Accrued</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued_lbl" xml:lang="en-US" id="id_14062202_3071658_2_1">Company's accrued liability for interest and penalties related to income tax liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued" xlink:to="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3071193_1_1">Income Tax Expense (Benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3071193_2_1">Income tax expense (benefit)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_IncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3071193_6_1">Income tax provision, Total</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_IncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3071193_14_1">Income tax (provision) benefit</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedTerseLabel" xlink:label="us-gaap_IncomeTaxExpenseBenefit_lbl" xml:lang="en-US" id="id_14062202_3071193_18_1">Income tax provision</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeTaxExpenseBenefit" xlink:to="us-gaap_IncomeTaxExpenseBenefit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability" xlink:label="us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability_lbl" xml:lang="en-US" id="id_14062202_3071660_1_1">Income Tax Expense (Benefit), Continuing Operations, Adjustment of Deferred Tax (Asset) Liability</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability_lbl" xml:lang="en-US" id="id_14062202_3071660_2_1">Income tax benefit resulting from the reduction of deferred tax liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability" xlink:to="us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncomeTaxExpenseForExcessTaxDeficiencies" xlink:label="md_IncomeTaxExpenseForExcessTaxDeficiencies"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_IncomeTaxExpenseForExcessTaxDeficiencies_lbl" xml:lang="en-US" id="id_14062202_3119724_3_1">Income tax expense for excess tax deficiencies.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_IncomeTaxExpenseForExcessTaxDeficiencies_lbl" xml:lang="en-US" id="id_14062202_3119724_1_1">Income Tax Expense For Excess Tax Deficiencies</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_IncomeTaxExpenseForExcessTaxDeficiencies_lbl" xml:lang="en-US" id="id_14062202_3119724_2_1">Income tax expense for excess tax deficiencies</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_IncomeTaxExpenseForExcessTaxDeficiencies" xlink:to="md_IncomeTaxExpenseForExcessTaxDeficiencies_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncomeTaxLineItems" xlink:label="md_IncomeTaxLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_IncomeTaxLineItems_lbl" xml:lang="en-US" id="id_14062202_3085689_3_1">Income Tax [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_IncomeTaxLineItems_lbl" xml:lang="en-US" id="id_14062202_3085689_1_1">Income Tax [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_IncomeTaxLineItems_lbl" xml:lang="en-US" id="id_14062202_3085689_2_1">Income Tax [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_IncomeTaxLineItems" xlink:to="md_IncomeTaxLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxPolicyTextBlock" xlink:label="us-gaap_IncomeTaxPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncomeTaxPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3071663_1_1">Income Tax, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncomeTaxPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3071663_2_1">Income Taxes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncomeTaxPolicyTextBlock" xlink:to="us-gaap_IncomeTaxPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncomeTaxTable" xlink:label="md_IncomeTaxTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_IncomeTaxTable_lbl" xml:lang="en-US" id="id_14062202_3239568_3_1">Income Tax [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_IncomeTaxTable_lbl" xml:lang="en-US" id="id_14062202_3239568_1_1">Income Tax [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_IncomeTaxTable_lbl" xml:lang="en-US" id="id_14062202_3239568_2_1">Income Tax [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_IncomeTaxTable" xlink:to="md_IncomeTaxTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities" xlink:label="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities_lbl" xml:lang="en-US" id="id_14062202_3071682_1_1">Increase (Decrease) in Accounts Payable and Accrued Liabilities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities_lbl" xml:lang="en-US" id="id_14062202_3071682_2_1">Accounts payable and accrued expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities" xlink:to="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccountsReceivable" xlink:label="us-gaap_IncreaseDecreaseInAccountsReceivable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInAccountsReceivable_lbl" xml:lang="en-US" id="id_14062202_3071933_1_1">Increase (Decrease) in Accounts Receivable</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_IncreaseDecreaseInAccountsReceivable_lbl" xml:lang="en-US" id="id_14062202_3071933_14_1">Accounts receivable</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncreaseDecreaseInAccountsReceivable" xlink:to="us-gaap_IncreaseDecreaseInAccountsReceivable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable" xlink:label="us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable_lbl" xml:lang="en-US" id="id_14062202_3071684_1_1">Increase (Decrease) in Income Taxes Payable</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable_lbl" xml:lang="en-US" id="id_14062202_3071684_2_1">Income taxes payable</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable" xlink:to="us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInDeferredLiabilities" xlink:label="us-gaap_IncreaseDecreaseInDeferredLiabilities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInDeferredLiabilities_lbl" xml:lang="en-US" id="id_14062202_3071227_1_1">Increase (Decrease) in Deferred Liabilities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncreaseDecreaseInDeferredLiabilities_lbl" xml:lang="en-US" id="id_14062202_3071227_2_1">Increase (decrease) in net deferred tax liability</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncreaseDecreaseInDeferredLiabilities" xlink:to="us-gaap_IncreaseDecreaseInDeferredLiabilities_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:label="md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts_lbl" xml:lang="en-US" id="id_14062202_3541367_3_1">Increase decrease in deferred tax assets tax deferred expense reserves and accruals allowance for doubtful accounts.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts_lbl" xml:lang="en-US" id="id_14062202_3541367_1_1">Increase Decrease in Deferred Tax Assets, Tax Deferred Expense, Reserves and Accruals, Allowance for Doubtful Accounts</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts_lbl" xml:lang="en-US" id="id_14062202_3541367_2_1">Increase in allowance for uncollectible accounts</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:to="md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" xlink:label="md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals_lbl" xml:lang="en-US" id="id_14062202_3541369_3_1">Increase decrease in deferred tax liabilities deferred expense reserves and accruals.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals_lbl" xml:lang="en-US" id="id_14062202_3541369_1_1">Increase Decrease in Deferred Tax Liabilities, Deferred Expense, Reserves and Accruals</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals_lbl" xml:lang="en-US" id="id_14062202_3541369_2_1">Decrease in accrual to cash adjustment</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" xlink:to="md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve" xlink:label="us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve_lbl" xml:lang="en-US" id="id_14062202_3071250_1_1">Increase (Decrease) in Liability for Claims and Claims Adjustment Expense Reserve</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve_lbl" xml:lang="en-US" id="id_14062202_3071250_2_1">Long-term professional liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve" xlink:to="us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:label="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract_lbl" xml:lang="en-US" id="id_14062202_3072194_1_1">Increase (Decrease) in Operating Capital [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract_lbl" xml:lang="en-US" id="id_14062202_3072194_2_1">Changes in assets and liabilities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInOtherNoncurrentAssets" xlink:label="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets_lbl" xml:lang="en-US" id="id_14062202_3071734_1_1">Increase (Decrease) in Other Noncurrent Assets</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets_lbl" xml:lang="en-US" id="id_14062202_3071734_14_1">Other long-term assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets" xlink:to="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInOtherOperatingLiabilities" xlink:label="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities_lbl" xml:lang="en-US" id="id_14062202_3072620_1_1">Increase (Decrease) in Other Operating Liabilities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities_lbl" xml:lang="en-US" id="id_14062202_3072620_2_1">Other liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities" xlink:to="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets" xlink:label="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets_lbl" xml:lang="en-US" id="id_14062202_3071267_1_1">Increase (Decrease) in Prepaid Expense and Other Assets</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets_lbl" xml:lang="en-US" id="id_14062202_3071267_14_1">Prepaid expenses and other current assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets" xlink:to="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" xlink:label="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements_lbl" xml:lang="en-US" id="id_14062202_3072650_1_1">Incremental Common Shares Attributable to Dilutive Effect of Share-based Payment Arrangements</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements_lbl" xml:lang="en-US" id="id_14062202_3072650_2_1">Weighted average number of dilutive common share equivalents</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" xlink:to="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InsuranceSettlementsReceivable" xlink:label="us-gaap_InsuranceSettlementsReceivable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InsuranceSettlementsReceivable_lbl" xml:lang="en-US" id="id_14062202_3072247_1_1">Insurance Settlements Receivable</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InsuranceSettlementsReceivable_lbl" xml:lang="en-US" id="id_14062202_3072247_2_1">Insurance receivables</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InsuranceSettlementsReceivable" xlink:to="us-gaap_InsuranceSettlementsReceivable_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_InterestAndPenaltiesMember" xlink:label="md_InterestAndPenaltiesMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_InterestAndPenaltiesMember_lbl" xml:lang="en-US" id="id_14062202_3268616_3_1">Interest and penalties.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_InterestAndPenaltiesMember_lbl" xml:lang="en-US" id="id_14062202_3268616_1_1">Interest And Penalties [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_InterestAndPenaltiesMember_lbl" xml:lang="en-US" id="id_14062202_3268616_2_1">Interest and Penalties [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_InterestAndPenaltiesMember" xlink:to="md_InterestAndPenaltiesMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InterestExpense" xlink:label="us-gaap_InterestExpense"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InterestExpense_lbl" xml:lang="en-US" id="id_14062202_3071986_1_1">Interest Expense</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_InterestExpense_lbl" xml:lang="en-US" id="id_14062202_3071986_14_1">Interest expense</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InterestExpense" xlink:to="us-gaap_InterestExpense_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InterestPaidNet" xlink:label="us-gaap_InterestPaidNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InterestPaidNet_lbl" xml:lang="en-US" id="id_14062202_3072747_1_1">Interest Paid, Excluding Capitalized Interest, Operating Activities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InterestPaidNet_lbl" xml:lang="en-US" id="id_14062202_3072747_2_1">Interest</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InterestPaidNet" xlink:to="us-gaap_InterestPaidNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InterestPayableCurrent" xlink:label="us-gaap_InterestPayableCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InterestPayableCurrent_lbl" xml:lang="en-US" id="id_14062202_3072748_1_1">Interest Payable, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InterestPayableCurrent_lbl" xml:lang="en-US" id="id_14062202_3072748_2_1">Accrued interest</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InterestPayableCurrent" xlink:to="us-gaap_InterestPayableCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_InternalRevenueCodeSection481Member" xlink:label="md_InternalRevenueCodeSection481Member"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_InternalRevenueCodeSection481Member_lbl" xml:lang="en-US" id="id_14062202_3541682_3_1">Internal Revenue Code Section 481 [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_InternalRevenueCodeSection481Member_lbl" xml:lang="en-US" id="id_14062202_3541682_1_1">Internal Revenue Code Section 481 [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_InternalRevenueCodeSection481Member_lbl" xml:lang="en-US" id="id_14062202_3541682_2_1">Internal Revenue Code Section 481 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_InternalRevenueCodeSection481Member" xlink:to="md_InternalRevenueCodeSection481Member_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentIncomeNet" xlink:label="us-gaap_InvestmentIncomeNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentIncomeNet_lbl" xml:lang="en-US" id="id_14062202_3073264_1_1">Investment Income, Net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentIncomeNet_lbl" xml:lang="en-US" id="id_14062202_3073264_2_1">Investment and other income</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentIncomeNet" xlink:to="us-gaap_InvestmentIncomeNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentPolicyTextBlock" xlink:label="us-gaap_InvestmentPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3072126_1_1">Investment, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3072126_2_1">Investments</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentPolicyTextBlock" xlink:to="us-gaap_InvestmentPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock" xlink:label="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3073506_1_1">Investments Classified by Contractual Maturity Date [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3073506_2_1">Schedule of Contractual Maturities of Long-Term Investments</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock" xlink:to="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract_lbl" xml:lang="en-US" id="id_14062202_3073064_1_1">Investments, Debt and Equity Securities [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract_lbl" xml:lang="en-US" id="id_14062202_3073064_2_1">Investments, Debt and Equity Securities [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" xlink:label="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3073078_1_1">Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3073078_2_1">Investments</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" xlink:to="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/invest/2013/invest-2013-01-31.xsd#invest_InvestmentsScheduleAbstract" xlink:label="invest_InvestmentsScheduleAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="invest_InvestmentsScheduleAbstract_lbl" xml:lang="en-US" id="id_14062202_3073294_1_1">Investments Schedule [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="invest_InvestmentsScheduleAbstract_lbl" xml:lang="en-US" id="id_14062202_3073294_2_1">Investments Schedule [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="invest_InvestmentsScheduleAbstract" xlink:to="invest_InvestmentsScheduleAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentTypeAxis" xlink:label="us-gaap_InvestmentTypeAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentTypeAxis_lbl" xml:lang="en-US" id="id_14062202_3073527_1_1">Investment Type [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentTypeAxis_lbl" xml:lang="en-US" id="id_14062202_3073527_2_1">Investment Type [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentTypeAxis" xlink:to="us-gaap_InvestmentTypeAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentTypeCategorizationMember" xlink:label="us-gaap_InvestmentTypeCategorizationMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_InvestmentTypeCategorizationMember_lbl" xml:lang="en-US" id="id_14062202_3073090_1_1">Investments [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_InvestmentTypeCategorizationMember_lbl" xml:lang="en-US" id="id_14062202_3073090_2_1">Investments [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_InvestmentTypeCategorizationMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Land" xlink:label="us-gaap_Land"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_Land_lbl" xml:lang="en-US" id="id_14062202_3073125_1_1">Land</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_Land_lbl" xml:lang="en-US" id="id_14062202_3073125_2_1">Land</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_Land" xlink:to="us-gaap_Land_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LatestTaxYearMember" xlink:label="us-gaap_LatestTaxYearMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LatestTaxYearMember_lbl" xml:lang="en-US" id="id_14062202_3073129_1_1">Latest Tax Year [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LatestTaxYearMember_lbl" xml:lang="en-US" id="id_14062202_3073129_2_1">Latest Tax Year [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LatestTaxYearMember" xlink:to="us-gaap_LatestTaxYearMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LeaseAndRentalExpense" xlink:label="us-gaap_LeaseAndRentalExpense"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LeaseAndRentalExpense_lbl" xml:lang="en-US" id="id_14062202_3073564_1_1">Operating Leases, Rent Expense</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LeaseAndRentalExpense_lbl" xml:lang="en-US" id="id_14062202_3073564_2_1">Rent expense</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LeaseAndRentalExpense" xlink:to="us-gaap_LeaseAndRentalExpense_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LetterOfCreditMember" xlink:label="us-gaap_LetterOfCreditMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LetterOfCreditMember_lbl" xml:lang="en-US" id="id_14062202_3073193_1_1">Letter of Credit [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LetterOfCreditMember_lbl" xml:lang="en-US" id="id_14062202_3073193_2_1">Letters of Credit [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LetterOfCreditMember" xlink:to="us-gaap_LetterOfCreditMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LettersOfCreditOutstandingAmount" xlink:label="us-gaap_LettersOfCreditOutstandingAmount"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LettersOfCreditOutstandingAmount_lbl" xml:lang="en-US" id="id_14062202_3073194_1_1">Letters of Credit Outstanding, Amount</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LettersOfCreditOutstandingAmount_lbl" xml:lang="en-US" id="id_14062202_3073194_2_1">Letters of credit outstanding amount</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LettersOfCreditOutstandingAmount" xlink:to="us-gaap_LettersOfCreditOutstandingAmount_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Liabilities" xlink:label="us-gaap_Liabilities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_Liabilities_lbl" xml:lang="en-US" id="id_14062202_3073419_1_1">Liabilities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_Liabilities_lbl" xml:lang="en-US" id="id_14062202_3073419_6_1">Total liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_Liabilities" xlink:to="us-gaap_Liabilities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquity" xlink:label="us-gaap_LiabilitiesAndStockholdersEquity"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LiabilitiesAndStockholdersEquity_lbl" xml:lang="en-US" id="id_14062202_3073420_1_1">Liabilities and Equity</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_LiabilitiesAndStockholdersEquity_lbl" xml:lang="en-US" id="id_14062202_3073420_6_1">Total liabilities and shareholders' equity</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LiabilitiesAndStockholdersEquity" xlink:to="us-gaap_LiabilitiesAndStockholdersEquity_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:label="us-gaap_LiabilitiesAndStockholdersEquityAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LiabilitiesAndStockholdersEquityAbstract_lbl" xml:lang="en-US" id="id_14062202_3073204_1_1">Liabilities and Equity [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LiabilitiesAndStockholdersEquityAbstract_lbl" xml:lang="en-US" id="id_14062202_3073204_2_1">LIABILITIES &amp; SHAREHOLDERS' EQUITY</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_LiabilitiesAndStockholdersEquityAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesCurrent" xlink:label="us-gaap_LiabilitiesCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LiabilitiesCurrent_lbl" xml:lang="en-US" id="id_14062202_3072894_1_1">Liabilities, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_LiabilitiesCurrent_lbl" xml:lang="en-US" id="id_14062202_3072894_6_1">Total current liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LiabilitiesCurrent" xlink:to="us-gaap_LiabilitiesCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_3073422_1_1">Liabilities, Current [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LiabilitiesCurrentAbstract_lbl" xml:lang="en-US" id="id_14062202_3073422_2_1">Current liabilities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LiabilitiesCurrentAbstract" xlink:to="us-gaap_LiabilitiesCurrentAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityCommitmentFeePercentage" xlink:label="us-gaap_LineOfCreditFacilityCommitmentFeePercentage"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LineOfCreditFacilityCommitmentFeePercentage_lbl" xml:lang="en-US" id="id_14062202_3074399_1_1">Line of Credit Facility, Commitment Fee Percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LineOfCreditFacilityCommitmentFeePercentage_lbl" xml:lang="en-US" id="id_14062202_3074399_2_1">Commitment fee percentage</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LineOfCreditFacilityCommitmentFeePercentage" xlink:to="us-gaap_LineOfCreditFacilityCommitmentFeePercentage_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityExpirationDate1" xlink:label="us-gaap_LineOfCreditFacilityExpirationDate1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LineOfCreditFacilityExpirationDate1_lbl" xml:lang="en-US" id="id_14062202_3074401_1_1">Line of Credit Facility, Expiration Date</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LineOfCreditFacilityExpirationDate1_lbl" xml:lang="en-US" id="id_14062202_3074401_2_1">Line of Credit facility, maturity date</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LineOfCreditFacilityExpirationDate1" xlink:to="us-gaap_LineOfCreditFacilityExpirationDate1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" xlink:label="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity_lbl" xml:lang="en-US" id="id_14062202_3074404_1_1">Line of Credit Facility, Maximum Borrowing Capacity</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity_lbl" xml:lang="en-US" id="id_14062202_3074404_2_1">Line of Credit facility, borrowing capacity</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" xlink:to="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity" xlink:label="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity_lbl" xml:lang="en-US" id="id_14062202_3072977_1_1">Line of Credit Facility, Remaining Borrowing Capacity</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity_lbl" xml:lang="en-US" id="id_14062202_3072977_2_1">Line of Credit facility, available balance</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity" xlink:to="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityTable" xlink:label="us-gaap_LineOfCreditFacilityTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LineOfCreditFacilityTable_lbl" xml:lang="en-US" id="id_14062202_3074406_1_1">Line of Credit Facility [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LineOfCreditFacilityTable_lbl" xml:lang="en-US" id="id_14062202_3074406_2_1">Line of Credit Facility [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_LineOfCreditFacilityTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LondonInterbankOfferedRateLIBORMember" xlink:label="us-gaap_LondonInterbankOfferedRateLIBORMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LondonInterbankOfferedRateLIBORMember_lbl" xml:lang="en-US" id="id_14062202_3074465_1_1">London Interbank Offered Rate (LIBOR) [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LondonInterbankOfferedRateLIBORMember_lbl" xml:lang="en-US" id="id_14062202_3074465_2_1">LIBOR [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LondonInterbankOfferedRateLIBORMember" xlink:to="us-gaap_LondonInterbankOfferedRateLIBORMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LongTermDebt" xlink:label="us-gaap_LongTermDebt"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LongTermDebt_lbl" xml:lang="en-US" id="id_14062202_3073715_1_1">Long-term Debt</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LongTermDebt_lbl" xml:lang="en-US" id="id_14062202_3073715_2_1">Long term debt</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LongTermDebt" xlink:to="us-gaap_LongTermDebt_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent" xlink:label="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent_lbl" xml:lang="en-US" id="id_14062202_3074059_1_1">Long-term Debt and Capital Lease Obligations, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent_lbl" xml:lang="en-US" id="id_14062202_3074059_2_1">Current portion of long-term debt and capital lease obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent" xlink:to="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" xlink:label="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit_lbl" xml:lang="en-US" id="id_14062202_3186252_3_1">Long term debt and capital lease obligations excluding long term line of credit.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit_lbl" xml:lang="en-US" id="id_14062202_3186252_1_1">Long Term Debt and Capital Lease Obligations Excluding Long Term Line of Credit</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit_lbl" xml:lang="en-US" id="id_14062202_3186252_2_1">Long-term debt and capital lease obligations, net</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" xlink:to="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_LongTermInvestmentsMaturityPeriod" xlink:label="md_LongTermInvestmentsMaturityPeriod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_LongTermInvestmentsMaturityPeriod_lbl" xml:lang="en-US" id="id_14062202_3225548_3_1">Long term investments maturity period.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_LongTermInvestmentsMaturityPeriod_lbl" xml:lang="en-US" id="id_14062202_3225548_1_1">Long Term Investments Maturity Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_LongTermInvestmentsMaturityPeriod_lbl" xml:lang="en-US" id="id_14062202_3225548_2_1">Long-term investments maturity period, in years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_LongTermInvestmentsMaturityPeriod" xlink:to="md_LongTermInvestmentsMaturityPeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LongTermLineOfCredit" xlink:label="us-gaap_LongTermLineOfCredit"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_LongTermLineOfCredit_lbl" xml:lang="en-US" id="id_14062202_3074501_1_1">Long-term Line of Credit, Noncurrent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_LongTermLineOfCredit_lbl" xml:lang="en-US" id="id_14062202_3074501_2_1">Line of credit</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_LongTermLineOfCredit" xlink:to="us-gaap_LongTermLineOfCredit_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyAccrualUndiscounted" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_lbl" xml:lang="en-US" id="id_14062202_3073800_1_1">Malpractice Loss Contingency, Accrual, Undiscounted</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_lbl" xml:lang="en-US" id="id_14062202_3073800_4_1">Balance at end of year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_lbl" xml:lang="en-US" id="id_14062202_3073800_5_1">Balance at beginning of year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_lbl" xml:lang="en-US" id="id_14062202_3073800_2_1">Total accrued professional liability</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyAccrualUndiscounted" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_3074330_1_1">Malpractice Loss Contingency, Accrual, Undiscounted, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent_lbl" xml:lang="en-US" id="id_14062202_3074330_2_1">Accrued professional liabilities</label>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent_lbl" xml:lang="en-US" id="id_14062202_3075225_1_1">Malpractice Loss Contingency, Accrual, Undiscounted, Noncurrent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent_lbl" xml:lang="en-US" id="id_14062202_3075225_2_1">Long-term professional liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod_lbl" xml:lang="en-US" id="id_14062202_3074779_1_1">Malpractice Loss Contingency, Claims Incurred in Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod_lbl" xml:lang="en-US" id="id_14062202_3074779_14_1">Claim payments related to Current year</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod" xlink:to="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods_lbl" xml:lang="en-US" id="id_14062202_3074780_1_1">Malpractice Loss Contingency, Claims Incurred in Prior Periods</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods_lbl" xml:lang="en-US" id="id_14062202_3074780_14_1">Claim payments related to Prior years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods" xlink:to="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredNet" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredNet_lbl" xml:lang="en-US" id="id_14062202_3074331_1_1">Malpractice Loss Contingency, Claims Incurred, Net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedTotalLabel" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredNet_lbl" xml:lang="en-US" id="id_14062202_3074331_19_1">Total payments</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyClaimsIncurredNet" xlink:to="us-gaap_MalpracticeLossContingencyClaimsIncurredNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyDisclosureTextBlock" xlink:label="us-gaap_MalpracticeLossContingencyDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MalpracticeLossContingencyDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3074989_1_1">Malpractice Loss Contingency Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MalpracticeLossContingencyDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3074989_2_1">Accrued Professional Liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyDisclosureTextBlock" xlink:to="us-gaap_MalpracticeLossContingencyDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_MalpracticeLossContingencyProvisionForLosses" xlink:label="md_MalpracticeLossContingencyProvisionForLosses"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_MalpracticeLossContingencyProvisionForLosses_lbl" xml:lang="en-US" id="id_14062202_3168832_3_1">Malpractice loss contingency provision for losses.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_MalpracticeLossContingencyProvisionForLosses_lbl" xml:lang="en-US" id="id_14062202_3168832_1_1">Malpractice Loss Contingency Provision For Losses</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="md_MalpracticeLossContingencyProvisionForLosses_lbl" xml:lang="en-US" id="id_14062202_3168832_6_1">Total provision for losses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_MalpracticeLossContingencyProvisionForLosses" xlink:to="md_MalpracticeLossContingencyProvisionForLosses_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ManagementServiceMember" xlink:label="us-gaap_ManagementServiceMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ManagementServiceMember_lbl" xml:lang="en-US" id="id_14062202_3073813_1_1">Management Service [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ManagementServiceMember_lbl" xml:lang="en-US" id="id_14062202_3073813_2_1">Management Services [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ManagementServiceMember" xlink:to="us-gaap_ManagementServiceMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.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_14062202_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_14062202_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_14062202_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="md-20181231.xsd#md_MaternalFetalMedicineMember" xlink:label="md_MaternalFetalMedicineMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_MaternalFetalMedicineMember_lbl" xml:lang="en-US" id="id_14062202_3253056_3_1">Maternal fetal medicine.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_MaternalFetalMedicineMember_lbl" xml:lang="en-US" id="id_14062202_3253056_1_1">Maternal Fetal Medicine [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_MaternalFetalMedicineMember_lbl" xml:lang="en-US" id="id_14062202_3253056_2_1">Maternal-Fetal Medicine [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_MaternalFetalMedicineMember" xlink:to="md_MaternalFetalMedicineMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/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_14062202_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_14062202_3074821_2_1">Maximum [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="srt_MaximumMember" xlink:to="srt_MaximumMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" xlink:label="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember_lbl" xml:lang="en-US" id="id_14062202_3252751_3_1">Medical and other equipment held under capital lease.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember_lbl" xml:lang="en-US" id="id_14062202_3252751_1_1">Medical And Other Equipment Held Under Capital Lease [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember_lbl" xml:lang="en-US" id="id_14062202_3252751_2_1">Medical and Other Equipment Held under Capital Lease [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" xlink:to="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="srt_MinimumMember_lbl" xml:lang="en-US" id="id_14062202_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_14062202_3075282_2_1">Minimum [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="srt_MinimumMember" xlink:to="srt_MinimumMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_MoneyMarketFundsAtFairValue" xlink:label="md_MoneyMarketFundsAtFairValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_MoneyMarketFundsAtFairValue_lbl" xml:lang="en-US" id="id_14062202_3135919_3_1">Money market funds at fair value.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_MoneyMarketFundsAtFairValue_lbl" xml:lang="en-US" id="id_14062202_3135919_1_1">Money Market Funds At Fair Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_MoneyMarketFundsAtFairValue_lbl" xml:lang="en-US" id="id_14062202_3135919_2_1">Money market funds fair value</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_MoneyMarketFundsAtFairValue" xlink:to="md_MoneyMarketFundsAtFairValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NatureOfOperations" xlink:label="us-gaap_NatureOfOperations"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NatureOfOperations_lbl" xml:lang="en-US" id="id_14062202_3074596_1_1">Nature of Operations [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NatureOfOperations_lbl" xml:lang="en-US" id="id_14062202_3074596_2_1">General</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NatureOfOperations" xlink:to="us-gaap_NatureOfOperations_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NeonatologyAndOtherPediatricSubspecialtiesMember" xlink:label="md_NeonatologyAndOtherPediatricSubspecialtiesMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NeonatologyAndOtherPediatricSubspecialtiesMember_lbl" xml:lang="en-US" id="id_14062202_3253054_3_1">Neonatology and other pediatric subspecialties.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NeonatologyAndOtherPediatricSubspecialtiesMember_lbl" xml:lang="en-US" id="id_14062202_3253054_1_1">Neonatology And Other Pediatric Subspecialties [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NeonatologyAndOtherPediatricSubspecialtiesMember_lbl" xml:lang="en-US" id="id_14062202_3253054_2_1">Neonatology and Other Pediatric Subspecialties [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NeonatologyAndOtherPediatricSubspecialtiesMember" xlink:to="md_NeonatologyAndOtherPediatricSubspecialtiesMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_3075138_6_1">Net cash (used in) provided from financing activities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract"/>
    <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_14062202_3075384_1_1">Net Cash Provided by (Used in) Financing Activities [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract_lbl" xml:lang="en-US" id="id_14062202_3075384_2_1">Cash flows from financing activities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivities"/>
    <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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_NetIncomeLoss" xlink:label="us-gaap_NetIncomeLoss"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetIncomeLoss_lbl" xml:lang="en-US" id="id_14062202_3075391_1_1">Net Income (Loss) Attributable to Parent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_NetIncomeLoss_lbl" xml:lang="en-US" id="id_14062202_3075391_6_1">Net income attributable to MEDNAX, Inc.</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetIncomeLoss" xlink:to="us-gaap_NetIncomeLoss_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest_lbl" xml:lang="en-US" id="id_14062202_3075392_1_1">Net Income (Loss) Attributable to Noncontrolling Interest</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest_lbl" xml:lang="en-US" id="id_14062202_3075392_14_1">Net loss attributable to noncontrolling interests</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" xlink:to="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NetOperatingLossCarryForwardsExpirationDate" xlink:label="md_NetOperatingLossCarryForwardsExpirationDate"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NetOperatingLossCarryForwardsExpirationDate_lbl" xml:lang="en-US" id="id_14062202_3214583_3_1">Net operating loss carry forwards expiration date.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NetOperatingLossCarryForwardsExpirationDate_lbl" xml:lang="en-US" id="id_14062202_3214583_1_1">Net Operating Loss Carry Forwards Expiration Date</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NetOperatingLossCarryForwardsExpirationDate_lbl" xml:lang="en-US" id="id_14062202_3214583_2_1">Expiration period of operating loss carryforwards</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NetOperatingLossCarryForwardsExpirationDate" xlink:to="md_NetOperatingLossCarryForwardsExpirationDate_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_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_NoncontrollingInterestMember" xlink:label="us-gaap_NoncontrollingInterestMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NoncontrollingInterestMember_lbl" xml:lang="en-US" id="id_14062202_3076080_1_1">Noncontrolling Interest [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NoncontrollingInterestMember_lbl" xml:lang="en-US" id="id_14062202_3076080_2_1">Noncontrolling Interests [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NoncontrollingInterestMember" xlink:to="us-gaap_NoncontrollingInterestMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_3074676_1_1">Nonoperating Income (Expense)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NonoperatingIncomeExpense_lbl" xml:lang="en-US" id="id_14062202_3074676_2_1">Total non-operating expenses</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_NonoperatingIncomeExpense_lbl" xml:lang="en-US" id="id_14062202_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_14062202_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_14062202_3074689_2_1">Estimated fair value</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-20181231.xsd#md_NumberOfMaternalfetalMedicinePracticesAcquired" xlink:label="md_NumberOfMaternalfetalMedicinePracticesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfMaternalfetalMedicinePracticesAcquired_lbl" xml:lang="en-US" id="id_14062202_3219323_3_1">Number of maternal-fetal medicine practices acquired.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NumberOfMaternalfetalMedicinePracticesAcquired_lbl" xml:lang="en-US" id="id_14062202_3219323_1_1">Number Of Maternal-fetal Medicine Practices Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NumberOfMaternalfetalMedicinePracticesAcquired_lbl" xml:lang="en-US" id="id_14062202_3219323_2_1">Number of maternal-fetal medicine practices acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NumberOfMaternalfetalMedicinePracticesAcquired" xlink:to="md_NumberOfMaternalfetalMedicinePracticesAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.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_14062202_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_14062202_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_14062202_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-20181231.xsd#md_NumberOfPediatricMultiSpecialtyPracticesAcquired" xlink:label="md_NumberOfPediatricMultiSpecialtyPracticesAcquired"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_NumberOfPediatricMultiSpecialtyPracticesAcquired_lbl" xml:lang="en-US" id="id_14062202_3215516_3_1">Number of pediatric multi-specialty practices acquired.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_NumberOfPediatricMultiSpecialtyPracticesAcquired_lbl" xml:lang="en-US" id="id_14062202_3215516_1_1">Number Of Pediatric Multi Specialty Practices Acquired</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_NumberOfPediatricMultiSpecialtyPracticesAcquired_lbl" xml:lang="en-US" id="id_14062202_3215516_2_1">Number of pediatric multi-specialty practice acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NumberOfPediatricMultiSpecialtyPracticesAcquired" xlink:to="md_NumberOfPediatricMultiSpecialtyPracticesAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.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_14062202_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_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_OpenTaxYear" xlink:label="us-gaap_OpenTaxYear"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OpenTaxYear_lbl" xml:lang="en-US" id="id_14062202_3075921_1_1">Open Tax Year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OpenTaxYear_lbl" xml:lang="en-US" id="id_14062202_3075921_2_1">Federal and state income tax examinations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OpenTaxYear" xlink:to="us-gaap_OpenTaxYear_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_3075924_1_1">Operating Expenses</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingExpenses_lbl" xml:lang="en-US" id="id_14062202_3075924_2_1">Total operating expenses</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_OperatingExpenses_lbl" xml:lang="en-US" id="id_14062202_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_14062202_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_14062202_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_14062202_3076165_1_1">Operating Income (Loss)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingIncomeLoss_lbl" xml:lang="en-US" id="id_14062202_3076165_2_1">Income from operations</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_OperatingIncomeLoss_lbl" xml:lang="en-US" id="id_14062202_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_OperatingLeasesFutureMinimumPaymentsDue" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDue_lbl" xml:lang="en-US" id="id_14062202_3075932_1_1">Operating Leases, Future Minimum Payments Due</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDue_lbl" xml:lang="en-US" id="id_14062202_3075932_6_1">Total</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent_lbl" xml:lang="en-US" id="id_14062202_3076173_1_1">Operating Leases, Future Minimum Payments Due, Next Twelve Months</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent_lbl" xml:lang="en-US" id="id_14062202_3076173_2_1">2019</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears_lbl" xml:lang="en-US" id="id_14062202_3076174_1_1">Operating Leases, Future Minimum Payments, Due in Five Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears_lbl" xml:lang="en-US" id="id_14062202_3076174_2_1">2023</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears_lbl" xml:lang="en-US" id="id_14062202_3076176_1_1">Operating Leases, Future Minimum Payments, Due in Four Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears_lbl" xml:lang="en-US" id="id_14062202_3076176_2_1">2022</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears_lbl" xml:lang="en-US" id="id_14062202_3075775_1_1">Operating Leases, Future Minimum Payments, Due in Three Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears_lbl" xml:lang="en-US" id="id_14062202_3075775_2_1">2021</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears_lbl" xml:lang="en-US" id="id_14062202_3075935_1_1">Operating Leases, Future Minimum Payments, Due in Two Years</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears_lbl" xml:lang="en-US" id="id_14062202_3075935_2_1">2020</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter_lbl" xml:lang="en-US" id="id_14062202_3074749_1_1">Operating Leases, Future Minimum Payments, Due Thereafter</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter_lbl" xml:lang="en-US" id="id_14062202_3074749_2_1">Thereafter</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLossCarryforwards" xlink:label="us-gaap_OperatingLossCarryforwards"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OperatingLossCarryforwards_lbl" xml:lang="en-US" id="id_14062202_3075943_1_1">Operating Loss Carryforwards</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OperatingLossCarryforwards_lbl" xml:lang="en-US" id="id_14062202_3075943_2_1">Net operating loss carryforwards for federal and state tax</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OperatingLossCarryforwards" xlink:to="us-gaap_OperatingLossCarryforwards_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_OtherOwnershipInterestsByNameAxis" xlink:label="us-gaap_OtherOwnershipInterestsByNameAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OtherOwnershipInterestsByNameAxis_lbl" xml:lang="en-US" id="id_14062202_3076720_1_1">Other Ownership Interests Name [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OtherOwnershipInterestsByNameAxis_lbl" xml:lang="en-US" id="id_14062202_3076720_2_1">Other Ownership Interests Name [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OtherOwnershipInterestsByNameAxis" xlink:to="us-gaap_OtherOwnershipInterestsByNameAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherOwnershipInterestsNameDomain" xlink:label="us-gaap_OtherOwnershipInterestsNameDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OtherOwnershipInterestsNameDomain_lbl" xml:lang="en-US" id="id_14062202_3075554_1_1">Other Ownership Interests, Name [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OtherOwnershipInterestsNameDomain_lbl" xml:lang="en-US" id="id_14062202_3075554_2_1">Other Ownership Interests, Name [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OtherOwnershipInterestsNameDomain" xlink:to="us-gaap_OtherOwnershipInterestsNameDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PatentedAndOtherTechnologyMember" xlink:label="md_PatentedAndOtherTechnologyMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PatentedAndOtherTechnologyMember_lbl" xml:lang="en-US" id="id_14062202_3253046_3_1">Patented and other technology.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PatentedAndOtherTechnologyMember_lbl" xml:lang="en-US" id="id_14062202_3253046_1_1">Patented And Other Technology [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PatentedAndOtherTechnologyMember_lbl" xml:lang="en-US" id="id_14062202_3253046_2_1">Patented and Other Technology [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PatentedAndOtherTechnologyMember" xlink:to="md_PatentedAndOtherTechnologyMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_PaymentsOfFinancingCosts" xlink:label="us-gaap_PaymentsOfFinancingCosts"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentsOfFinancingCosts_lbl" xml:lang="en-US" id="id_14062202_3076303_1_1">Payments of Financing Costs</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_PaymentsOfFinancingCosts_lbl" xml:lang="en-US" id="id_14062202_3076303_14_1">Payments for financing costs</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentsOfFinancingCosts" xlink:to="us-gaap_PaymentsOfFinancingCosts_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PaymentsToAcquireBusinessesGross" xlink:label="us-gaap_PaymentsToAcquireBusinessesGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PaymentsToAcquireBusinessesGross_lbl" xml:lang="en-US" id="id_14062202_3077085_1_1">Payments to Acquire Businesses, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PaymentsToAcquireBusinessesGross_lbl" xml:lang="en-US" id="id_14062202_3077085_2_1">Additional cash consideration related to a working capital true up</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PaymentsToAcquireBusinessesGross" xlink:to="us-gaap_PaymentsToAcquireBusinessesGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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-20181231.xsd#md_PediatricCardiologyMember" xlink:label="md_PediatricCardiologyMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PediatricCardiologyMember_lbl" xml:lang="en-US" id="id_14062202_3317063_3_1">Pediatric cardiology.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PediatricCardiologyMember_lbl" xml:lang="en-US" id="id_14062202_3317063_1_1">Pediatric Cardiology [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PediatricCardiologyMember_lbl" xml:lang="en-US" id="id_14062202_3317063_2_1">Pediatric Cardiology [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PediatricCardiologyMember" xlink:to="md_PediatricCardiologyMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" xlink:label="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3077109_1_1">Pension and Other Postretirement Benefits Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3077109_2_1">Retirement Plans</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" xlink:to="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.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_14062202_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_14062202_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_14062202_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-20181231.xsd#md_PhysicianAndHospitalAgreementsMember" xlink:label="md_PhysicianAndHospitalAgreementsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PhysicianAndHospitalAgreementsMember_lbl" xml:lang="en-US" id="id_14062202_3294255_3_1">Physician And Hospital Agreements [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PhysicianAndHospitalAgreementsMember_lbl" xml:lang="en-US" id="id_14062202_3294255_1_1">Physician And Hospital Agreements [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PhysicianAndHospitalAgreementsMember_lbl" xml:lang="en-US" id="id_14062202_3294255_2_1">Physician And Hospital Agreements [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PhysicianAndHospitalAgreementsMember" xlink:to="md_PhysicianAndHospitalAgreementsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PortionAtFairValueFairValueDisclosureMember" xlink:label="us-gaap_PortionAtFairValueFairValueDisclosureMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PortionAtFairValueFairValueDisclosureMember_lbl" xml:lang="en-US" id="id_14062202_3077791_1_1">Portion at Fair Value Measurement [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PortionAtFairValueFairValueDisclosureMember_lbl" xml:lang="en-US" id="id_14062202_3077791_2_1">Portion at Fair Value Measurement [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PortionAtFairValueFairValueDisclosureMember" xlink:to="us-gaap_PortionAtFairValueFairValueDisclosureMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.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_14062202_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_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_ProceedsAndExcessTaxBenefitFromSharebasedCompensation" xlink:label="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation_lbl" xml:lang="en-US" id="id_14062202_3077676_1_1">Proceeds and Excess Tax Benefit from Share-based Compensation</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation_lbl" xml:lang="en-US" id="id_14062202_3077676_2_1">Cash proceeds received from the exercise of stock options</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation" xlink:to="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_ProceedsFromIssuanceOfSeniorLongTermDebt" xlink:label="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt_lbl" xml:lang="en-US" id="id_14062202_3077899_1_1">Proceeds from Issuance of Senior Long-term Debt</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt_lbl" xml:lang="en-US" id="id_14062202_3077899_2_1">Proceeds from issuance of senior notes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt" xlink:to="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProductConcentrationRiskMember" xlink:label="us-gaap_ProductConcentrationRiskMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProductConcentrationRiskMember_lbl" xml:lang="en-US" id="id_14062202_3078245_1_1">Product Concentration Risk [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProductConcentrationRiskMember_lbl" xml:lang="en-US" id="id_14062202_3078245_2_1">Product Concentration Risk [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProductConcentrationRiskMember" xlink:to="us-gaap_ProductConcentrationRiskMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/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_14062202_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_14062202_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_14062202_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_14062202_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="md-20181231.xsd#md_ProfessionalLiabilityCoveragePolicyTextBlock" xlink:label="md_ProfessionalLiabilityCoveragePolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ProfessionalLiabilityCoveragePolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3345729_3_1">Professional liability coverage policy.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ProfessionalLiabilityCoveragePolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3345729_1_1">Professional Liability Coverage Policy [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ProfessionalLiabilityCoveragePolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3345729_2_1">Professional Liability Coverage</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ProfessionalLiabilityCoveragePolicyTextBlock" xlink:to="md_ProfessionalLiabilityCoveragePolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_14062202_3078267_6_1">Net income</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_ProfitLoss_lbl" xml:lang="en-US" id="id_14062202_3078267_12_1">Net income (loss)</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProfitLoss" xlink:to="us-gaap_ProfitLoss_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentAbstract" xlink:label="us-gaap_PropertyPlantAndEquipmentAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentAbstract_lbl" xml:lang="en-US" id="id_14062202_3078271_1_1">Property, Plant and Equipment [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentAbstract_lbl" xml:lang="en-US" id="id_14062202_3078271_2_1">Property, Plant and Equipment [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis_lbl" xml:lang="en-US" id="id_14062202_3078429_1_1">Property, Plant and Equipment, Type [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis_lbl" xml:lang="en-US" id="id_14062202_3078429_2_1">Property, Plant and Equipment, Type [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract" xlink:label="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract_lbl" xml:lang="en-US" id="id_14062202_3087862_3_1">Property Plant And Equipment Capitalized Interest Costs [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract_lbl" xml:lang="en-US" id="id_14062202_3087862_1_1">Property Plant And Equipment Capitalized Interest Costs [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract_lbl" xml:lang="en-US" id="id_14062202_3087862_2_1">Property Plant And Equipment Capitalized Interest Costs [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract" xlink:to="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3077985_1_1">Property, Plant and Equipment Disclosure [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock_lbl" xml:lang="en-US" id="id_14062202_3077985_2_1">Property and Equipment</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock" xlink:to="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentGross" xlink:label="us-gaap_PropertyPlantAndEquipmentGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentGross_lbl" xml:lang="en-US" id="id_14062202_3078637_1_1">Property, Plant and Equipment, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentGross_lbl" xml:lang="en-US" id="id_14062202_3078637_2_1">Medical and other equipment held under capital leases</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentGross_lbl" xml:lang="en-US" id="id_14062202_3078637_6_1">Property and equipment, gross</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentGross" xlink:to="us-gaap_PropertyPlantAndEquipmentGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentLineItems" xlink:label="us-gaap_PropertyPlantAndEquipmentLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentLineItems_lbl" xml:lang="en-US" id="id_14062202_3078642_1_1">Property, Plant and Equipment [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentLineItems_lbl" xml:lang="en-US" id="id_14062202_3078642_2_1">Property, Plant and Equipment [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_3077229_2_1">Property and equipment, net</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentNet_lbl" xml:lang="en-US" id="id_14062202_3077229_6_1">Property and equipment, net</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentNet" xlink:to="us-gaap_PropertyPlantAndEquipmentNet_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3078434_1_1">Property, Plant and Equipment, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3078434_2_1">Property and Equipment</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" xlink:to="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentTextBlock_lbl" xml:lang="en-US" id="id_14062202_3078284_1_1">Property, Plant and Equipment [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentTextBlock_lbl" xml:lang="en-US" id="id_14062202_3078284_2_1">Schedule of Property and Equipment</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentTextBlock" xlink:to="us-gaap_PropertyPlantAndEquipmentTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain_lbl" xml:lang="en-US" id="id_14062202_3078646_1_1">Property, Plant and Equipment, Type [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain_lbl" xml:lang="en-US" id="id_14062202_3078646_2_1">Property, Plant and Equipment, Type [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:label="us-gaap_PropertyPlantAndEquipmentUsefulLife"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_PropertyPlantAndEquipmentUsefulLife_lbl" xml:lang="en-US" id="id_14062202_3078647_1_1">Property, Plant and Equipment, Useful Life</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_PropertyPlantAndEquipmentUsefulLife_lbl" xml:lang="en-US" id="id_14062202_3078647_2_1">Property and equipment estimated useful lives, years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:to="us-gaap_PropertyPlantAndEquipmentUsefulLife_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ProvisionAdjustmentForLossesRelatedToCurrentYear" xlink:label="md_ProvisionAdjustmentForLossesRelatedToCurrentYear"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ProvisionAdjustmentForLossesRelatedToCurrentYear_lbl" xml:lang="en-US" id="id_14062202_3172511_3_1">Provision (adjustment) for losses related to current year.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ProvisionAdjustmentForLossesRelatedToCurrentYear_lbl" xml:lang="en-US" id="id_14062202_3172511_1_1">Provision Adjustment For Losses Related To Current Year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ProvisionAdjustmentForLossesRelatedToCurrentYear_lbl" xml:lang="en-US" id="id_14062202_3172511_2_1">Provision (adjustment) for losses related to Current year</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ProvisionAdjustmentForLossesRelatedToCurrentYear" xlink:to="md_ProvisionAdjustmentForLossesRelatedToCurrentYear_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ProvisionAdjustmentForLossesRelatedToPriorYear" xlink:label="md_ProvisionAdjustmentForLossesRelatedToPriorYear"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ProvisionAdjustmentForLossesRelatedToPriorYear_lbl" xml:lang="en-US" id="id_14062202_3128751_3_1">Provision (adjustment) for losses related to prior year.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ProvisionAdjustmentForLossesRelatedToPriorYear_lbl" xml:lang="en-US" id="id_14062202_3128751_1_1">Provision Adjustment For Losses Related To Prior Year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ProvisionAdjustmentForLossesRelatedToPriorYear_lbl" xml:lang="en-US" id="id_14062202_3128751_2_1">Provision (adjustment) for losses related to Prior years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ProvisionAdjustmentForLossesRelatedToPriorYear" xlink:to="md_ProvisionAdjustmentForLossesRelatedToPriorYear_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3078510_1_1">Quarterly Financial Information Disclosure [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract_lbl" xml:lang="en-US" id="id_14062202_3078510_2_1">Quarterly Financial Information Disclosure [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_QuarterlyFinancialInformationDisclosureAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_QuarterlyFinancialInformationTextBlock" xlink:label="us-gaap_QuarterlyFinancialInformationTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_QuarterlyFinancialInformationTextBlock_lbl" xml:lang="en-US" id="id_14062202_3078511_1_1">Quarterly Financial Information [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_QuarterlyFinancialInformationTextBlock_lbl" xml:lang="en-US" id="id_14062202_3078511_2_1">Selected Quarterly Financial Information</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_QuarterlyFinancialInformationTextBlock" xlink:to="us-gaap_QuarterlyFinancialInformationTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_RadiologyAndTeleradiologyMember" xlink:label="md_RadiologyAndTeleradiologyMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_RadiologyAndTeleradiologyMember_lbl" xml:lang="en-US" id="id_14062202_3245705_3_1">Radiology and teleradiology.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_RadiologyAndTeleradiologyMember_lbl" xml:lang="en-US" id="id_14062202_3245705_1_1">Radiology And Teleradiology [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_RadiologyAndTeleradiologyMember_lbl" xml:lang="en-US" id="id_14062202_3245705_2_1">Radiology And Teleradiology [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_RadiologyAndTeleradiologyMember" xlink:to="md_RadiologyAndTeleradiologyMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/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_14062202_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_14062202_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_14062202_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_14062202_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_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis" xlink:label="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis_lbl" xml:lang="en-US" id="id_14062202_3078734_1_1">Nature of Uncertainty [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis_lbl" xml:lang="en-US" id="id_14062202_3078734_2_1">Nature of Uncertainty [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis" xlink:to="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_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="md-20181231.xsd#md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" xlink:label="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember_lbl" xml:lang="en-US" id="id_14062202_3332561_3_1">Redeem up to thirty five percentage of aggregate principal amount.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember_lbl" xml:lang="en-US" id="id_14062202_3332561_1_1">Redeem Up to Thirty Five Percentage of Aggregate Principal Amount [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember_lbl" xml:lang="en-US" id="id_14062202_3332561_2_1">Redeem up to 35% of Aggregate Principal Amount [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" xlink:to="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_RegulatoryAssetsAbstract" xlink:label="md_RegulatoryAssetsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_RegulatoryAssetsAbstract_lbl" xml:lang="en-US" id="id_14062202_3091258_3_1">Regulatory Assets [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_RegulatoryAssetsAbstract_lbl" xml:lang="en-US" id="id_14062202_3091258_1_1">Regulatory Assets [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_RegulatoryAssetsAbstract_lbl" xml:lang="en-US" id="id_14062202_3091258_2_1">Regulatory Assets [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_RegulatoryAssetsAbstract" xlink:to="md_RegulatoryAssetsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_14062202_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_14062202_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="md-20181231.xsd#md_RestrictedAndDeferredStockUnitsMember" xlink:label="md_RestrictedAndDeferredStockUnitsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_RestrictedAndDeferredStockUnitsMember_lbl" xml:lang="en-US" id="id_14062202_3291163_3_1">Restricted and deferred stock units.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_RestrictedAndDeferredStockUnitsMember_lbl" xml:lang="en-US" id="id_14062202_3291163_1_1">Restricted And Deferred Stock Units [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_RestrictedAndDeferredStockUnitsMember_lbl" xml:lang="en-US" id="id_14062202_3291163_2_1">Restricted and Deferred Stock Units [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_RestrictedAndDeferredStockUnitsMember" xlink:to="md_RestrictedAndDeferredStockUnitsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_RetainedEarningsMember" xlink:label="us-gaap_RetainedEarningsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RetainedEarningsMember_lbl" xml:lang="en-US" id="id_14062202_3078149_1_1">Retained Earnings [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RetainedEarningsMember_lbl" xml:lang="en-US" id="id_14062202_3078149_2_1">Retained Earnings [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RetainedEarningsMember" xlink:to="us-gaap_RetainedEarningsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_3079398_1_1">Revenue from Contract with Customer, Including Assessed Tax</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax_lbl" xml:lang="en-US" id="id_14062202_3079398_2_1">Net revenue</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax" xlink:to="us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueRecognitionPolicyTextBlock" xlink:label="us-gaap_RevenueRecognitionPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RevenueRecognitionPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079231_1_1">Revenue Recognition, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RevenueRecognitionPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079231_2_1">Revenue Recognition</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RevenueRecognitionPolicyTextBlock" xlink:to="us-gaap_RevenueRecognitionPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevolvingCreditFacilityMember" xlink:label="us-gaap_RevolvingCreditFacilityMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RevolvingCreditFacilityMember_lbl" xml:lang="en-US" id="id_14062202_3078864_1_1">Revolving Credit Facility [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RevolvingCreditFacilityMember_lbl" xml:lang="en-US" id="id_14062202_3078864_2_1">Revolving Credit Facility [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RevolvingCreditFacilityMember" xlink:to="us-gaap_RevolvingCreditFacilityMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SaleOfMinorityInterestPercentage" xlink:label="md_SaleOfMinorityInterestPercentage"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_SaleOfMinorityInterestPercentage_lbl" xml:lang="en-US" id="id_14062202_3368387_3_1">Sale of minority interest percentage.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_SaleOfMinorityInterestPercentage_lbl" xml:lang="en-US" id="id_14062202_3368387_1_1">Sale Of Minority Interest Percentage</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_SaleOfMinorityInterestPercentage_lbl" xml:lang="en-US" id="id_14062202_3368387_2_1">Sale of minority interest percentage</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_SaleOfMinorityInterestPercentage" xlink:to="md_SaleOfMinorityInterestPercentage_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SalesRevenueServicesNetMember" xlink:label="us-gaap_SalesRevenueServicesNetMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SalesRevenueServicesNetMember_lbl" xml:lang="en-US" id="id_14062202_3078903_1_1">Sales Revenue, Services, Net [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SalesRevenueServicesNetMember_lbl" xml:lang="en-US" id="id_14062202_3078903_2_1">Sales Revenue, Services, Net [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SalesRevenueServicesNetMember" xlink:to="us-gaap_SalesRevenueServicesNetMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioForecastMember" xlink:label="us-gaap_ScenarioForecastMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScenarioForecastMember_lbl" xml:lang="en-US" id="id_14062202_3078919_1_1">Scenario, Forecast [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScenarioForecastMember_lbl" xml:lang="en-US" id="id_14062202_3078919_2_1">Scenario, Forecast [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScenarioForecastMember" xlink:to="us-gaap_ScenarioForecastMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioUnspecifiedDomain" xlink:label="us-gaap_ScenarioUnspecifiedDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScenarioUnspecifiedDomain_lbl" xml:lang="en-US" id="id_14062202_3079283_1_1">Scenario, Unspecified [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScenarioUnspecifiedDomain_lbl" xml:lang="en-US" id="id_14062202_3079283_2_1">Scenario, Unspecified [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScenarioUnspecifiedDomain" xlink:to="us-gaap_ScenarioUnspecifiedDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable_lbl" xml:lang="en-US" id="id_14062202_3078920_1_1">Schedule of Accounts, Notes, Loans and Financing Receivable [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable_lbl" xml:lang="en-US" id="id_14062202_3078920_2_1">Schedule of Accounts, Notes, Loans and Financing Receivable [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable" xlink:to="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079493_1_1">Schedule of Accounts, Notes, Loans and Financing Receivable [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079493_2_1">Schedule of Accounts Receivable, Net</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock" xlink:to="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock" xlink:label="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079284_1_1">Schedule of Accounts Payable and Accrued Liabilities [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079284_2_1">Schedule of Accounts Payable and Accrued Expenses</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock" xlink:to="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock" xlink:label="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3351257_3_1">Schedule of accrued professional liability.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3351257_1_1">Schedule Of Accrued Professional Liability [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3351257_2_1">Schedule of Accrued Professional Liability</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock" xlink:to="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable_lbl" xml:lang="en-US" id="id_14062202_3079672_1_1">Schedule of Business Acquisitions, by Acquisition [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable_lbl" xml:lang="en-US" id="id_14062202_3079672_2_1">Schedule of Business Acquisitions, by Acquisition [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ScheduleOfCapitalLeaseObligationsTableTextBlock" xlink:label="md_ScheduleOfCapitalLeaseObligationsTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ScheduleOfCapitalLeaseObligationsTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3352382_3_1">Schedule of capital lease obligations.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ScheduleOfCapitalLeaseObligationsTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3352382_1_1">Schedule Of Capital Lease Obligations [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ScheduleOfCapitalLeaseObligationsTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3352382_2_1">Schedule of Capital Lease Obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ScheduleOfCapitalLeaseObligationsTableTextBlock" xlink:to="md_ScheduleOfCapitalLeaseObligationsTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" xlink:label="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3078939_1_1">Schedule of Components of Income Tax Expense (Benefit) [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3078939_2_1">Summary of Components of Income Tax Provision</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" xlink:to="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfDebtTableTextBlock" xlink:label="us-gaap_ScheduleOfDebtTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfDebtTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079965_1_1">Schedule of Debt [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfDebtTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079965_2_1">Schedule of Long-Term Debt</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfDebtTableTextBlock" xlink:to="us-gaap_ScheduleOfDebtTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" xlink:label="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079966_1_1">Schedule of Deferred Tax Assets and Liabilities [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079966_2_1">Significant Components of Deferred Income Tax Assets and Liabilities</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" xlink:to="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" xlink:label="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079696_1_1">Schedule of Effective Income Tax Rate Reconciliation [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079696_2_1">Schedule of Differences Between Effective Rate and United States Federal Income Tax Statutory Rate</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" xlink:to="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis" xlink:label="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis_lbl" xml:lang="en-US" id="id_14062202_3079978_1_1">Investment, Name [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis_lbl" xml:lang="en-US" id="id_14062202_3079978_2_1">Investment, Name [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis" xlink:to="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ScheduleOfFinancingReceivablesLineItems" xlink:label="md_ScheduleOfFinancingReceivablesLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ScheduleOfFinancingReceivablesLineItems_lbl" xml:lang="en-US" id="id_14062202_3086951_3_1">Schedule of financing receivables.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ScheduleOfFinancingReceivablesLineItems_lbl" xml:lang="en-US" id="id_14062202_3086951_1_1">Schedule Of Financing Receivables [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ScheduleOfFinancingReceivablesLineItems_lbl" xml:lang="en-US" id="id_14062202_3086951_2_1">Schedule Of Financing Receivables [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ScheduleOfFinancingReceivablesLineItems" xlink:to="md_ScheduleOfFinancingReceivablesLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable_lbl" xml:lang="en-US" id="id_14062202_3079711_1_1">Schedule of Finite-Lived Intangible Assets [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable_lbl" xml:lang="en-US" id="id_14062202_3079711_2_1">Schedule of Finite-Lived Intangible Assets [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080210_1_1">Schedule of Finite-Lived Intangible Assets [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080210_2_1">Summary of Intangible Assets, Net</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" xlink:to="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock" xlink:label="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080212_1_1">Schedule of Future Minimum Lease Payments for Capital Leases [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080212_2_1">Schedule of Amounts Due Under Terms of Capital Lease Obligations</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock" xlink:to="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" xlink:label="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3078958_1_1">Schedule of Future Minimum Rental Payments for Operating Leases [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3078958_2_1">Schedule of Future Minimum Lease Payments under Non-Cancelable Operating Leases</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" xlink:to="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems" xlink:label="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems_lbl" xml:lang="en-US" id="id_14062202_3079989_1_1">Schedule of Held-to-maturity Securities [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems_lbl" xml:lang="en-US" id="id_14062202_3079989_2_1">Schedule of Held-to-maturity Securities [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems" xlink:to="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems_lbl"/>
    <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_14062202_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_14062202_3079717_2_1">Debt Securities, Held-to-maturity [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfHeldToMaturitySecuritiesTable" xlink:to="us-gaap_ScheduleOfHeldToMaturitySecuritiesTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:label="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable_lbl" xml:lang="en-US" id="id_14062202_3078983_1_1">Property, Plant and Equipment [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable_lbl" xml:lang="en-US" id="id_14062202_3078983_2_1">Property, Plant and Equipment [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:to="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock" xlink:label="us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080236_1_1">Quarterly Financial Information [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080236_2_1">Summary of Company's Selected Quarterly Financial Information</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock" xlink:to="us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable" xlink:label="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable_lbl" xml:lang="en-US" id="id_14062202_3080244_1_1">Schedule of Revenue Sources, Health Care Organization [Table]</label>
    <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_14062202_3080244_2_1">Schedule of Revenue Sources, Health Care Organization [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable" xlink:to="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" xlink:label="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable_lbl" xml:lang="en-US" id="id_14062202_3080422_1_1">Schedule of Segment Reporting Information, by Segment [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable_lbl" xml:lang="en-US" id="id_14062202_3080422_2_1">Schedule of Segment Reporting Information, by Segment [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" xlink:to="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfSegmentReportingInformationBySegmentTextBlock" xlink:label="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080423_1_1">Schedule of Segment Reporting Information, by Segment [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080423_2_1">Schedule of Net Revenue by Service Line</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTextBlock" xlink:to="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:label="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable"/>
    <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_14062202_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_14062202_3079002_2_1">Schedule of Share-based Compensation Arrangements by Share-based Payment Award [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock" xlink:label="us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080038_1_1">Schedule of Share-based Compensation, Restricted Stock Units Award Activity [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080038_2_1">Schedule of Restricted Stock and Deferred Stock Awards</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock" xlink:to="us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" xlink:label="us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080430_1_1">Share-based Compensation, Stock Options, Activity [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080430_2_1">Schedule of Activity and Certain Other Information Related to Stock Option Awards</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" xlink:to="us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock" xlink:label="us-gaap_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080048_1_1">Schedule of Weighted Average Number of Shares [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080048_2_1">Schedule of Calculation of Shares Used in Basic and Diluted Net Income Per Share</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock" xlink:to="us-gaap_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock" xlink:label="us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080440_1_1">Schedules of Concentration of Risk, by Risk Factor [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080440_2_1">Schedule of Percentage of Net Revenue</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock" xlink:to="us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SegmentDomain" xlink:label="us-gaap_SegmentDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SegmentDomain_lbl" xml:lang="en-US" id="id_14062202_3079730_1_1">Segments [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SegmentDomain_lbl" xml:lang="en-US" id="id_14062202_3079730_2_1">Segments [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SegmentDomain" xlink:to="us-gaap_SegmentDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SegmentReportingInformationLineItems" xlink:label="us-gaap_SegmentReportingInformationLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SegmentReportingInformationLineItems_lbl" xml:lang="en-US" id="id_14062202_3080092_1_1">Segment Reporting Information [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SegmentReportingInformationLineItems_lbl" xml:lang="en-US" id="id_14062202_3080092_2_1">Segment Reporting Information [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SegmentReportingInformationLineItems" xlink:to="us-gaap_SegmentReportingInformationLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SegmentReportingPolicyPolicyTextBlock" xlink:label="us-gaap_SegmentReportingPolicyPolicyTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SegmentReportingPolicyPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080485_1_1">Segment Reporting, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SegmentReportingPolicyPolicyTextBlock_lbl" xml:lang="en-US" id="id_14062202_3080485_2_1">Segment Reporting</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SegmentReportingPolicyPolicyTextBlock" xlink:to="us-gaap_SegmentReportingPolicyPolicyTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SelfInsuranceReserveCurrent" xlink:label="us-gaap_SelfInsuranceReserveCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SelfInsuranceReserveCurrent_lbl" xml:lang="en-US" id="id_14062202_3079735_1_1">Self Insurance Reserve, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SelfInsuranceReserveCurrent_lbl" xml:lang="en-US" id="id_14062202_3079735_2_1">Accrued professional liability incurred but loss reserves not reported for claims</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SelfInsuranceReserveCurrent" xlink:to="us-gaap_SelfInsuranceReserveCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SelfPayMember" xlink:label="us-gaap_SelfPayMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SelfPayMember_lbl" xml:lang="en-US" id="id_14062202_3080487_1_1">Self-Pay [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SelfPayMember_lbl" xml:lang="en-US" id="id_14062202_3080487_2_1">Private-Pay Patients [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SelfPayMember" xlink:to="us-gaap_SelfPayMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensation" xlink:label="us-gaap_ShareBasedCompensation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensation_lbl" xml:lang="en-US" id="id_14062202_3079780_1_1">Share-based Compensation</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensation_lbl" xml:lang="en-US" id="id_14062202_3079780_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_ShareBasedCompensation" xlink:to="us-gaap_ShareBasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1_lbl" xml:lang="en-US" id="id_14062202_3080374_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1_lbl" xml:lang="en-US" id="id_14062202_3080374_2_1">Award vesting period</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod_lbl" xml:lang="en-US" id="id_14062202_3080142_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeited in Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod_lbl" xml:lang="en-US" id="id_14062202_3080142_14_1">Number of Shares, Forfeited</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue_lbl" xml:lang="en-US" id="id_14062202_3080530_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeitures, Weighted Average Grant Date Fair Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue_lbl" xml:lang="en-US" id="id_14062202_3080530_2_1">Weighted Average Fair Value, Forfeited</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod"/>
    <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_14062202_3080378_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod_lbl" xml:lang="en-US" id="id_14062202_3080378_2_1">Number of Shares, Awarded</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue_lbl" xml:lang="en-US" id="id_14062202_3080532_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period, Weighted Average Grant Date Fair Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue_lbl" xml:lang="en-US" id="id_14062202_3080532_2_1">Weighted Average Fair Value, Awarded</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue_lbl" xml:lang="en-US" id="id_14062202_3080532_12_1">Weighted average grant-date fair value of restricted and deferred stock awards granted</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_lbl" xml:lang="en-US" id="id_14062202_3080379_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_lbl" xml:lang="en-US" id="id_14062202_3080379_4_1">Number of Shares, Non-vested shares at December 31, 2018</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_lbl" xml:lang="en-US" id="id_14062202_3080379_5_1">Number of Shares, Non-vested shares at January 1, 2018</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_lbl" xml:lang="en-US" id="id_14062202_3079787_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_lbl" xml:lang="en-US" id="id_14062202_3079787_4_1">Weighted Average Fair Value, Non-vested shares at December 31, 2018</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_lbl" xml:lang="en-US" id="id_14062202_3079787_5_1">Weighted Average Fair Value, Non-vested shares at January 1, 2018</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod_lbl" xml:lang="en-US" id="id_14062202_3080381_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod_lbl" xml:lang="en-US" id="id_14062202_3080381_14_1">Number of Shares, Vested</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue_lbl" xml:lang="en-US" id="id_14062202_3080383_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Fair Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue_lbl" xml:lang="en-US" id="id_14062202_3080383_2_1">Aggregate fair value of restricted and deferred stocks vested</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue_lbl" xml:lang="en-US" id="id_14062202_3080384_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Weighted Average Grant Date Fair Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue_lbl" xml:lang="en-US" id="id_14062202_3080384_2_1">Weighted Average Fair Value, Vested</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod_lbl" xml:lang="en-US" id="id_14062202_3079788_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period</label>
    <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_14062202_3079788_2_1">Vesting period of options, maximum years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems"/>
    <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_14062202_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_14062202_3080537_2_1">Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant_lbl" xml:lang="en-US" id="id_14062202_3080157_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant_lbl" xml:lang="en-US" id="id_14062202_3080157_2_1">Shares available for future grants and awards under Stock Incentive Plans</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1_lbl" xml:lang="en-US" id="id_14062202_3079795_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Intrinsic Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1_lbl" xml:lang="en-US" id="id_14062202_3079795_2_1">Aggregate Intrinsic Value, Exercisable at December 31, 2018</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber_lbl" xml:lang="en-US" id="id_14062202_3080542_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Number</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber_lbl" xml:lang="en-US" id="id_14062202_3080542_2_1">Number of Shares, Exercisable at December 31, 2017</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice_lbl" xml:lang="en-US" id="id_14062202_3080543_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Weighted Average Exercise Price</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice_lbl" xml:lang="en-US" id="id_14062202_3080543_2_1">Weighted Average Exercise Price, Exercisable at December 31, 2018</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1_lbl" xml:lang="en-US" id="id_14062202_3080158_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Weighted Average Remaining Contractual Term</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1_lbl" xml:lang="en-US" id="id_14062202_3080158_2_1">Weighted Average Remaining Contractual Term (in years), Exercisable at December 31, 2018</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue_lbl" xml:lang="en-US" id="id_14062202_3080544_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period, Intrinsic Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue_lbl" xml:lang="en-US" id="id_14062202_3080544_2_1">Aggregate intrinsic value of stock options exercised</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue_lbl" xml:lang="en-US" id="id_14062202_3080544_12_1">Aggregate Intrinsic Value, Exercised</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue_lbl" xml:lang="en-US" id="id_14062202_3081064_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Intrinsic Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue_lbl" xml:lang="en-US" id="id_14062202_3081064_4_1">Aggregate Intrinsic Value, Outstanding at December 31, 2018</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber_lbl" xml:lang="en-US" id="id_14062202_3080549_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Number</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber_lbl" xml:lang="en-US" id="id_14062202_3080549_4_1">Number of Shares, Outstanding at December 31, 2018</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber_lbl" xml:lang="en-US" id="id_14062202_3080549_5_1">Number of Shares, Outstanding at January 1, 2018</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice_lbl" xml:lang="en-US" id="id_14062202_3080551_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice_lbl" xml:lang="en-US" id="id_14062202_3080551_4_1">Weighted Average Exercise Price, Outstanding at December 31, 2018</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice_lbl" xml:lang="en-US" id="id_14062202_3080551_5_1">Weighted Average Exercise Price, Outstanding at January 1, 2018</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2_lbl" xml:lang="en-US" id="id_14062202_3079805_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2_lbl" xml:lang="en-US" id="id_14062202_3079805_2_1">Weighted Average Remaining Contractual Term (in years), Outstanding at December 31, 2018</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent"/>
    <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_14062202_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_14062202_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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <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_14062202_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_14062202_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_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice_lbl" xml:lang="en-US" id="id_14062202_3079818_1_1">Share-based Compensation Arrangements by Share-based Payment Award, Options, Exercises in Period, Weighted Average Exercise Price</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice_lbl" xml:lang="en-US" id="id_14062202_3079818_2_1">Weighted Average Exercise Price, Exercised</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy" xlink:label="us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy_lbl" xml:lang="en-US" id="id_14062202_3080831_1_1">Share-based Compensation, Option and Incentive Plans Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy_lbl" xml:lang="en-US" id="id_14062202_3080831_2_1">Stock Incentive Plans</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy" xlink:to="us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareRepurchaseProgramAxis" xlink:label="us-gaap_ShareRepurchaseProgramAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareRepurchaseProgramAxis_lbl" xml:lang="en-US" id="id_14062202_3081082_1_1">Share Repurchase Program [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareRepurchaseProgramAxis_lbl" xml:lang="en-US" id="id_14062202_3081082_2_1">Share Repurchase Program [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareRepurchaseProgramAxis" xlink:to="us-gaap_ShareRepurchaseProgramAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareRepurchaseProgramDomain" xlink:label="us-gaap_ShareRepurchaseProgramDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareRepurchaseProgramDomain_lbl" xml:lang="en-US" id="id_14062202_3080568_1_1">Share Repurchase Program [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareRepurchaseProgramDomain_lbl" xml:lang="en-US" id="id_14062202_3080568_2_1">Share Repurchase Program [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareRepurchaseProgramDomain" xlink:to="us-gaap_ShareRepurchaseProgramDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharesIssued" xlink:label="us-gaap_SharesIssued"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SharesIssued_lbl" xml:lang="en-US" id="id_14062202_3080569_1_1">Shares, Issued</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_SharesIssued_lbl" xml:lang="en-US" id="id_14062202_3080569_4_1">Balance, Shares</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_SharesIssued_lbl" xml:lang="en-US" id="id_14062202_3080569_5_1">Balance, Shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SharesIssued" xlink:to="us-gaap_SharesIssued_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_3226697_2_1">Short-Term investments maturity period, in years</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ShortTermInvestmentMaturityPeriod" xlink:to="md_ShortTermInvestmentMaturityPeriod_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SignificantAccountingPoliciesTextBlock" xlink:label="us-gaap_SignificantAccountingPoliciesTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SignificantAccountingPoliciesTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079878_1_1">Significant Accounting Policies [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SignificantAccountingPoliciesTextBlock_lbl" xml:lang="en-US" id="id_14062202_3079878_2_1">Summary of Significant Accounting Policies</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SignificantAccountingPoliciesTextBlock" xlink:to="us-gaap_SignificantAccountingPoliciesTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain" xlink:label="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain_lbl" xml:lang="en-US" id="id_14062202_3080603_1_1">Significant Change in Unrecognized Tax Benefits is Reasonably Possible, Nature of Uncertainty [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain_lbl" xml:lang="en-US" id="id_14062202_3080603_2_1">Significant Change in Unrecognized Tax Benefits is Reasonably Possible, Nature of Uncertainty [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain" xlink:to="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" xlink:label="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember_lbl" xml:lang="en-US" id="id_14062202_3538202_3_1">Six point two five percent senior unsecured notes due two thousand twenty seven.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember_lbl" xml:lang="en-US" id="id_14062202_3538202_1_1">Six Point Two Five Percent Senior Unsecured Notes Due Two Thousand Twenty Seven [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember_lbl" xml:lang="en-US" id="id_14062202_3538202_2_1">6.25% Senior Unsecured Notes Due 2027 [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" xlink:to="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SoftwareAndSoftwareDevelopmentCostsMember" xlink:label="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember_lbl" xml:lang="en-US" id="id_14062202_3081128_1_1">Software and Software Development Costs [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember_lbl" xml:lang="en-US" id="id_14062202_3081128_2_1">Software and Software Development Costs [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember" xlink:to="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations" xlink:label="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations_lbl" xml:lang="en-US" id="id_14062202_3080923_1_1">State and Local Income Tax Expense (Benefit), Continuing Operations</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations_lbl" xml:lang="en-US" id="id_14062202_3080923_6_1">State income tax provision, Total</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations" xlink:to="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations_lbl"/>
    <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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_StatementOfStockholdersEquityAbstract" xlink:label="us-gaap_StatementOfStockholdersEquityAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StatementOfStockholdersEquityAbstract_lbl" xml:lang="en-US" id="id_14062202_3080929_1_1">Statement of Stockholders' Equity [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StatementOfStockholdersEquityAbstract_lbl" xml:lang="en-US" id="id_14062202_3080929_2_1">Statement of Stockholders' Equity [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StatementOfStockholdersEquityAbstract" xlink:to="us-gaap_StatementOfStockholdersEquityAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementScenarioAxis" xlink:label="us-gaap_StatementScenarioAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StatementScenarioAxis_lbl" xml:lang="en-US" id="id_14062202_3081295_1_1">Scenario [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StatementScenarioAxis_lbl" xml:lang="en-US" id="id_14062202_3081295_2_1">Scenario [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StatementScenarioAxis" xlink:to="us-gaap_StatementScenarioAxis_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_14062202_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_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" xlink:label="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest_lbl" xml:lang="en-US" id="id_14062202_3079925_1_1">Stockholders' Equity, Including Portion Attributable to Noncontrolling Interest</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest_lbl" xml:lang="en-US" id="id_14062202_3079925_4_1">Balance</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest_lbl" xml:lang="en-US" id="id_14062202_3079925_5_1">Balance</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" xlink:to="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssued1" xlink:label="us-gaap_StockIssued1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssued1_lbl" xml:lang="en-US" id="id_14062202_3079932_1_1">Stock Issued</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockIssued1_lbl" xml:lang="en-US" id="id_14062202_3079932_2_1">Value of common stock issued for acquisitions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssued1" xlink:to="us-gaap_StockIssued1_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_14062202_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_14062202_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="md-20181231.xsd#md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_14062202_3201023_3_1">Stock issued during period shares restricted stock acquisition consideration.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_14062202_3201023_1_1">Stock Issued During Period Shares Restricted Stock Acquisition Consideration</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_14062202_3201023_2_1">Issuance of restricted stock for acquisition consideration, shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration" xlink:to="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" xlink:label="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited_lbl" xml:lang="en-US" id="id_14062202_3081325_1_1">Stock Issued During Period, Shares, Restricted Stock Award, Forfeited</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited_lbl" xml:lang="en-US" id="id_14062202_3081325_2_1">Forfeitures of restricted stock, shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" xlink:to="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation_lbl" xml:lang="en-US" id="id_14062202_3081326_1_1">Stock Issued During Period, Shares, Share-based Compensation, Net of Forfeitures</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation_lbl" xml:lang="en-US" id="id_14062202_3081326_2_1">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation" xlink:to="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross_lbl" xml:lang="en-US" id="id_14062202_3079937_1_1">Stock Issued During Period, Shares, Share-based Compensation, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross_lbl" xml:lang="en-US" id="id_14062202_3079937_2_1">Issuance of restricted stock, shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross" xlink:to="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" xlink:label="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised_lbl" xml:lang="en-US" id="id_14062202_3081328_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised_lbl" xml:lang="en-US" id="id_14062202_3081328_14_1">Number of Shares, Exercised</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" xlink:to="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_StockIssuedDuringPeriodSharesStockSwaps" xlink:label="md_StockIssuedDuringPeriodSharesStockSwaps"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_StockIssuedDuringPeriodSharesStockSwaps_lbl" xml:lang="en-US" id="id_14062202_3541365_3_1">Stock issued during period shares stock swaps.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_StockIssuedDuringPeriodSharesStockSwaps_lbl" xml:lang="en-US" id="id_14062202_3541365_1_1">Stock Issued During Period, Shares, Stock Swaps</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_StockIssuedDuringPeriodSharesStockSwaps_lbl" xml:lang="en-US" id="id_14062202_3541365_2_1">Stock swaps,shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_StockIssuedDuringPeriodSharesStockSwaps" xlink:to="md_StockIssuedDuringPeriodSharesStockSwaps_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_14062202_3189132_3_1">Stock issued during period value restricted stock acquisition consideration.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_14062202_3189132_1_1">Stock Issued During Period Value Restricted Stock Acquisition Consideration</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration_lbl" xml:lang="en-US" id="id_14062202_3189132_2_1">Issuance of restricted stock for acquisition consideration</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration" xlink:to="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" xlink:label="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures_lbl" xml:lang="en-US" id="id_14062202_3081334_1_1">Stock Issued During Period, Value, Restricted Stock Award, Forfeitures</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures_lbl" xml:lang="en-US" id="id_14062202_3081334_14_1">Forfeitures of restricted stock</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" xlink:to="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation_lbl" xml:lang="en-US" id="id_14062202_3081335_1_1">Stock Issued During Period, Value, Share-based Compensation, Net of Forfeitures</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation_lbl" xml:lang="en-US" id="id_14062202_3081335_2_1">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation" xlink:to="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross_lbl" xml:lang="en-US" id="id_14062202_3079945_1_1">Stock Issued During Period, Value, Share-based Compensation, Gross</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross_lbl" xml:lang="en-US" id="id_14062202_3079945_2_1">Issuance of restricted stock</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross" xlink:to="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_StockIssuedDuringPeriodValueStockSwaps" xlink:label="md_StockIssuedDuringPeriodValueStockSwaps"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_StockIssuedDuringPeriodValueStockSwaps_lbl" xml:lang="en-US" id="id_14062202_3541366_3_1">Stock issued during period value stock swaps.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_StockIssuedDuringPeriodValueStockSwaps_lbl" xml:lang="en-US" id="id_14062202_3541366_1_1">Stock Issued During Period Value Stock Swaps</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_StockIssuedDuringPeriodValueStockSwaps_lbl" xml:lang="en-US" id="id_14062202_3541366_2_1">Stock swaps</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_StockIssuedDuringPeriodValueStockSwaps" xlink:to="md_StockIssuedDuringPeriodValueStockSwaps_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_14062202_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_14062202_3081340_2_1">Repurchased common stock, shares</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_StockRepurchasedDuringPeriodShares_lbl" xml:lang="en-US" id="id_14062202_3081340_14_1">Repurchased common stock, shares</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockRepurchasedDuringPeriodShares" xlink:to="us-gaap_StockRepurchasedDuringPeriodShares_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_3081193_2_1">Common stock repurchased</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_StockRepurchasedDuringPeriodValue_lbl" xml:lang="en-US" id="id_14062202_3081193_14_1">Repurchased common stock</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_StockRepurchaseProgramAuthorizedAmount1" xlink:label="us-gaap_StockRepurchaseProgramAuthorizedAmount1"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockRepurchaseProgramAuthorizedAmount1_lbl" xml:lang="en-US" id="id_14062202_3080614_1_1">Stock Repurchase Program, Authorized Amount</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockRepurchaseProgramAuthorizedAmount1_lbl" xml:lang="en-US" id="id_14062202_3080614_2_1">Common stock authorized for repurchase</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockRepurchaseProgramAuthorizedAmount1" xlink:to="us-gaap_StockRepurchaseProgramAuthorizedAmount1_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SummaryOfEstimatedFairValueOfNotesTableTextBlock" xlink:label="md_SummaryOfEstimatedFairValueOfNotesTableTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_SummaryOfEstimatedFairValueOfNotesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3538153_3_1">Summary of Estimated Fair Value of Notes Table [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_SummaryOfEstimatedFairValueOfNotesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3538153_1_1">Summary of Estimated Fair Value of Notes Table [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_SummaryOfEstimatedFairValueOfNotesTableTextBlock_lbl" xml:lang="en-US" id="id_14062202_3538153_2_1">Summary of Estimated Fair Value of Notes</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_SummaryOfEstimatedFairValueOfNotesTableTextBlock" xlink:to="md_SummaryOfEstimatedFairValueOfNotesTableTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SummaryOfIncomeTaxContingenciesTextBlock" xlink:label="us-gaap_SummaryOfIncomeTaxContingenciesTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SummaryOfIncomeTaxContingenciesTextBlock_lbl" xml:lang="en-US" id="id_14062202_3081229_1_1">Summary of Income Tax Contingencies [Table Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SummaryOfIncomeTaxContingenciesTextBlock_lbl" xml:lang="en-US" id="id_14062202_3081229_2_1">Schedule of Activity Related to Gross Unrecognized Tax Benefits</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SummaryOfIncomeTaxContingenciesTextBlock" xlink:to="us-gaap_SummaryOfIncomeTaxContingenciesTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:label="md_SummaryOfSignificantAccountingPoliciesLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_SummaryOfSignificantAccountingPoliciesLineItems_lbl" xml:lang="en-US" id="id_14062202_3087173_3_1">Summary of significant accounting policies.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_SummaryOfSignificantAccountingPoliciesLineItems_lbl" xml:lang="en-US" id="id_14062202_3087173_1_1">Summary Of Significant Accounting Policies [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_SummaryOfSignificantAccountingPoliciesLineItems_lbl" xml:lang="en-US" id="id_14062202_3087173_2_1">Summary Of Significant Accounting Policies [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_SummaryOfSignificantAccountingPoliciesLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SummaryOfSignificantAccountingPoliciesTable" xlink:label="md_SummaryOfSignificantAccountingPoliciesTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_SummaryOfSignificantAccountingPoliciesTable_lbl" xml:lang="en-US" id="id_14062202_3238858_3_1">Summary Of Significant Accounting Policies [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_SummaryOfSignificantAccountingPoliciesTable_lbl" xml:lang="en-US" id="id_14062202_3238858_1_1">Summary Of Significant Accounting Policies [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_SummaryOfSignificantAccountingPoliciesTable_lbl" xml:lang="en-US" id="id_14062202_3238858_2_1">Summary Of Significant Accounting Policies [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="md_SummaryOfSignificantAccountingPoliciesTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SupplementalCashFlowInformationAbstract" xlink:label="us-gaap_SupplementalCashFlowInformationAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SupplementalCashFlowInformationAbstract_lbl" xml:lang="en-US" id="id_14062202_3081372_1_1">Supplemental Cash Flow Information [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SupplementalCashFlowInformationAbstract_lbl" xml:lang="en-US" id="id_14062202_3081372_2_1">Supplemental disclosure of cash flow information:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SupplementalCashFlowInformationAbstract" xlink:to="us-gaap_SupplementalCashFlowInformationAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxPeriodAxis" xlink:label="us-gaap_TaxPeriodAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_TaxPeriodAxis_lbl" xml:lang="en-US" id="id_14062202_3081022_1_1">Tax Period [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_TaxPeriodAxis_lbl" xml:lang="en-US" id="id_14062202_3081022_2_1">Tax Period [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_TaxPeriodAxis" xlink:to="us-gaap_TaxPeriodAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxPeriodDomain" xlink:label="us-gaap_TaxPeriodDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_TaxPeriodDomain_lbl" xml:lang="en-US" id="id_14062202_3080685_1_1">Tax Period [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_TaxPeriodDomain_lbl" xml:lang="en-US" id="id_14062202_3080685_2_1">Tax Period [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_TaxPeriodDomain" xlink:to="us-gaap_TaxPeriodDomain_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_14062202_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_14062202_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_14062202_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_14062202_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="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TradeNamesMember" xlink:label="us-gaap_TradeNamesMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_TradeNamesMember_lbl" xml:lang="en-US" id="id_14062202_3081468_1_1">Trade Names [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_TradeNamesMember_lbl" xml:lang="en-US" id="id_14062202_3081468_2_1">Trade Names [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_TradeNamesMember" xlink:to="us-gaap_TradeNamesMember_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_14062202_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_14062202_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-20181231.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_14062202_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_14062202_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_14062202_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="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnamortizedDebtIssuanceExpense" xlink:label="us-gaap_UnamortizedDebtIssuanceExpense"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnamortizedDebtIssuanceExpense_lbl" xml:lang="en-US" id="id_14062202_3080807_1_1">Unamortized Debt Issuance Expense</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_UnamortizedDebtIssuanceExpense_lbl" xml:lang="en-US" id="id_14062202_3080807_14_1">Unamortized debt issuance cost</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnamortizedDebtIssuanceExpense" xlink:to="us-gaap_UnamortizedDebtIssuanceExpense_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.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_14062202_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_14062202_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_14062202_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_UnrecognizedTaxBenefits" xlink:label="us-gaap_UnrecognizedTaxBenefits"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefits_lbl" xml:lang="en-US" id="id_14062202_3081825_1_1">Unrecognized Tax Benefits</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodEndLabel" xlink:label="us-gaap_UnrecognizedTaxBenefits_lbl" xml:lang="en-US" id="id_14062202_3081825_4_1">Balance at end of year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/periodStartLabel" xlink:label="us-gaap_UnrecognizedTaxBenefits_lbl" xml:lang="en-US" id="id_14062202_3081825_5_1">Balance at beginning of year</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_UnrecognizedTaxBenefits_lbl" xml:lang="en-US" id="id_14062202_3081825_2_1">Uncertain tax position liability</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefits" xlink:to="us-gaap_UnrecognizedTaxBenefits_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions" xlink:label="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions_lbl" xml:lang="en-US" id="id_14062202_3082224_1_1">Unrecognized Tax Benefits, Decrease Resulting from Prior Period Tax Positions</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions_lbl" xml:lang="en-US" id="id_14062202_3082224_14_1">Decreases related to prior year tax positions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions" xlink:to="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities" xlink:label="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities_lbl" xml:lang="en-US" id="id_14062202_3081498_1_1">Unrecognized Tax Benefits, Decrease Resulting from Settlements with Taxing Authorities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities_lbl" xml:lang="en-US" id="id_14062202_3081498_14_1">Settlements</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities" xlink:to="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate" xlink:label="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate_lbl" xml:lang="en-US" id="id_14062202_3144983_3_1">Unrecognized tax benefits impact effective tax rate.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate_lbl" xml:lang="en-US" id="id_14062202_3144983_1_1">Unrecognized Tax Benefits Impact Effective Tax Rate</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate_lbl" xml:lang="en-US" id="id_14062202_3144983_2_1">Effective income tax rate favorable impact of change in uncertain tax positions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate" xlink:to="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions" xlink:label="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions_lbl" xml:lang="en-US" id="id_14062202_3081827_1_1">Unrecognized Tax Benefits, Increase Resulting from Current Period Tax Positions</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions_lbl" xml:lang="en-US" id="id_14062202_3081827_2_1">Increases related to current year tax positions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions" xlink:to="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions" xlink:label="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions_lbl" xml:lang="en-US" id="id_14062202_3081502_1_1">Unrecognized Tax Benefits, Increase Resulting from Prior Period Tax Positions</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions_lbl" xml:lang="en-US" id="id_14062202_3081502_2_1">Increases related to prior year tax positions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions" xlink:to="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease" xlink:label="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_14062202_3081828_1_1">Unrecognized Tax Benefits, Period Increase (Decrease)</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease_lbl" xml:lang="en-US" id="id_14062202_3081828_2_1">Increase (decrease) in uncertain tax position</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease" xlink:to="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations" xlink:label="us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations_lbl" xml:lang="en-US" id="id_14062202_3081505_1_1">Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2009/role/negatedLabel" xlink:label="us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations_lbl" xml:lang="en-US" id="id_14062202_3081505_14_1">Decreases related to lapse of statutes of limitation</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations" xlink:to="us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate" xlink:label="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate_lbl" xml:lang="en-US" id="id_14062202_3082096_1_1">Unrecognized Tax Benefits that Would Impact Effective Tax Rate</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate_lbl" xml:lang="en-US" id="id_14062202_3082096_2_1">Unrecognized tax benefits that would impact effective tax rate</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate" xlink:to="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_UnsecuredRevolvingCreditFacilityMember" xlink:label="md_UnsecuredRevolvingCreditFacilityMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_UnsecuredRevolvingCreditFacilityMember_lbl" xml:lang="en-US" id="id_14062202_3336802_3_1">Unsecured Revolving Credit Facility [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_UnsecuredRevolvingCreditFacilityMember_lbl" xml:lang="en-US" id="id_14062202_3336802_1_1">Unsecured Revolving Credit Facility [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_UnsecuredRevolvingCreditFacilityMember_lbl" xml:lang="en-US" id="id_14062202_3336802_2_1">Unsecured Revolving Credit Facility [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_UnsecuredRevolvingCreditFacilityMember" xlink:to="md_UnsecuredRevolvingCreditFacilityMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UseOfEstimates" xlink:label="us-gaap_UseOfEstimates"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_UseOfEstimates_lbl" xml:lang="en-US" id="id_14062202_3082249_1_1">Use of Estimates, Policy [Policy Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_UseOfEstimates_lbl" xml:lang="en-US" id="id_14062202_3082249_2_1">Accounting Estimates and Assumptions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_UseOfEstimates" xlink:to="us-gaap_UseOfEstimates_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/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_14062202_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_14062202_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"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_USStatesAndPoliticalSubdivisionsMember_lbl" xml:lang="en-US" id="id_14062202_3081530_1_1">US States and Political Subdivisions Debt Securities [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_USStatesAndPoliticalSubdivisionsMember_lbl" xml:lang="en-US" id="id_14062202_3081530_2_1">Municipal Debt Securities [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_USStatesAndPoliticalSubdivisionsMember" xlink:to="us-gaap_USStatesAndPoliticalSubdivisionsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_VariableRateAxis" xlink:label="us-gaap_VariableRateAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_VariableRateAxis_lbl" xml:lang="en-US" id="id_14062202_3082302_1_1">Variable Rate [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_VariableRateAxis_lbl" xml:lang="en-US" id="id_14062202_3082302_2_1">Variable Rate [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_VariableRateAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_VariableRateDomain" xlink:label="us-gaap_VariableRateDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_VariableRateDomain_lbl" xml:lang="en-US" id="id_14062202_3082303_1_1">Variable Rate [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_VariableRateDomain_lbl" xml:lang="en-US" id="id_14062202_3082303_2_1">Variable Rate [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_VariableRateDomain" xlink:to="us-gaap_VariableRateDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding_lbl" xml:lang="en-US" id="id_14062202_3081601_1_1">Weighted Average Number of Shares Outstanding, Diluted</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding_lbl" xml:lang="en-US" id="id_14062202_3081601_2_1">Diluted</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding_lbl" xml:lang="en-US" id="id_14062202_3081601_6_1">Weighted average number of common and common equivalent shares outstanding</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding_lbl" xml:lang="en-US" id="id_14062202_3081601_12_1">Weighted average shares, Diluted</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:to="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic_lbl" xml:lang="en-US" id="id_14062202_3081604_1_1">Weighted Average Number of Shares Outstanding, Basic</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/positiveLabel" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic_lbl" xml:lang="en-US" id="id_14062202_3081604_32_1">Weighted average shares, Basic</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic_lbl" xml:lang="en-US" id="id_14062202_3081604_2_1">Basic</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/verboseLabel" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic_lbl" xml:lang="en-US" id="id_14062202_3081604_12_1">Weighted average number of common shares outstanding</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic_lbl"/>
  </labelLink>
</linkbase>
</XBRL>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.PRE
<SEQUENCE>16
<FILENAME>md-20181231_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: 4 -->
<!-- Creation date: 2019-02-13T01:59:33Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
<linkbase xmlns="http://www.xbrl.org/2003/linkbase"
  xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
  xmlns:xlink="http://www.w3.org/1999/xlink"
  xsi:schemaLocation="http://www.xbrl.org/2003/linkbase http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd">
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DocumentandEntityInformation" roleURI="http://www.mednax.com/taxonomy/role/DocumentandEntityInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfFinancialPositionClassified" roleURI="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassified"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfFinancialPositionClassifiedParen" roleURI="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassifiedParenthetical"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfIncomeAlternative" roleURI="http://www.mednax.com/taxonomy/role/StatementOfIncomeAlternative"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfShareholdersEquityAndOtherComprehensiveIncome" roleURI="http://www.mednax.com/taxonomy/role/StatementOfShareholdersEquityAndOtherComprehensiveIncome"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#StatementOfCashFlowsIndirect" roleURI="http://www.mednax.com/taxonomy/role/StatementOfCashFlowsIndirect"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine" roleURI="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureInvestmentsScheduleOfInvestments" roleURI="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfInvestments"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments" roleURI="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsReceivableAndNetRevenueAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment" roleURI="http://www.mednax.com/taxonomy/role/DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosurePropertyAndEquipmentAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosurePropertyAndEquipmentAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureBusinessAcquisitionsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureBusinessAcquisitionsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureGoodwillAndIntangibleAssetsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears" roleURI="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccruedProfessionalLiabilitiesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability" roleURI="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations" roleURI="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits" roleURI="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards" roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards" roleURI="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommonStockRepurchaseProgramsAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommonStockRepurchaseProgramsAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureRetirementPlansAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureRetirementPlansAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommitmentsAndContingenciesAdditionalInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesAdditionalInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases" roleURI="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation" roleURI="http://www.mednax.com/taxonomy/role/DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsNatureOfOperations" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsNatureOfOperations"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsIncomeTaxDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsEarningsPerShareTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsEarningsPerShareTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsCommonStockRepurchasesTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommonStockRepurchasesTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock"/>
  <roleRef xlink:type="simple" xlink:href="md-20181231.xsd#Role_NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables" roleURI="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables"/>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DocumentandEntityInformation">
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_AmendmentFlag" xlink:label="dei_AmendmentFlag"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_CurrentFiscalYearEndDate" xlink:label="dei_CurrentFiscalYearEndDate"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DocumentAndEntityInformationAbstract" xlink:label="md_DocumentAndEntityInformationAbstract"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentFiscalPeriodFocus" xlink:label="dei_DocumentFiscalPeriodFocus"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentFiscalYearFocus" xlink:label="dei_DocumentFiscalYearFocus"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentPeriodEndDate" xlink:label="dei_DocumentPeriodEndDate"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentType" xlink:label="dei_DocumentType"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityCentralIndexKey" xlink:label="dei_EntityCentralIndexKey"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityCommonStockSharesOutstanding" xlink:label="dei_EntityCommonStockSharesOutstanding"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityCurrentReportingStatus" xlink:label="dei_EntityCurrentReportingStatus"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityEmergingGrowthCompany" xlink:label="dei_EntityEmergingGrowthCompany"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityExTransitionPeriod" xlink:label="dei_EntityExTransitionPeriod"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityFilerCategory" xlink:label="dei_EntityFilerCategory"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityPublicFloat" xlink:label="dei_EntityPublicFloat"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityRegistrantName" xlink:label="dei_EntityRegistrantName"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityShellCompany" xlink:label="dei_EntityShellCompany"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntitySmallBusiness" xlink:label="dei_EntitySmallBusiness"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityVoluntaryFilers" xlink:label="dei_EntityVoluntaryFilers"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityWellKnownSeasonedIssuer" xlink:label="dei_EntityWellKnownSeasonedIssuer"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_TradingSymbol" xlink:label="dei_TradingSymbol"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_DocumentType" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_AmendmentFlag" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_DocumentPeriodEndDate" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_DocumentFiscalYearFocus" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_DocumentFiscalPeriodFocus" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_TradingSymbol" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityRegistrantName" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityCentralIndexKey" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_CurrentFiscalYearEndDate" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityWellKnownSeasonedIssuer" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityCurrentReportingStatus" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityVoluntaryFilers" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityFilerCategory" order="1.1300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityEmergingGrowthCompany" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityExTransitionPeriod" order="1.1500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityShellCompany" order="1.1600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntitySmallBusiness" order="1.1700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityCommonStockSharesOutstanding" order="1.1800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityPublicFloat" order="1.1900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassified">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" xlink:label="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableNetCurrent" xlink:label="us-gaap_AccountsReceivableNetCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccruedIncomeTaxesCurrent" xlink:label="us-gaap_AccruedIncomeTaxesCurrent"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesNoncurrent" xlink:label="us-gaap_DeferredTaxLiabilitiesNoncurrent"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HeldToMaturitySecuritiesNoncurrent" xlink:label="us-gaap_HeldToMaturitySecuritiesNoncurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Liabilities" xlink:label="us-gaap_Liabilities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquity" xlink:label="us-gaap_LiabilitiesAndStockholdersEquity"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:label="us-gaap_LiabilitiesAndStockholdersEquityAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesCurrent" xlink:label="us-gaap_LiabilitiesCurrent"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent" xlink:label="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" xlink:label="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LongTermLineOfCredit" xlink:label="us-gaap_LongTermLineOfCredit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_AssetsCurrentAbstract" order="1.1800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_RestrictedCashNoncurrent" order="1.1900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_HeldToMaturitySecuritiesNoncurrent" order="1.2000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentNet" order="1.2100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_Goodwill" order="1.2200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsNet" order="1.2300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_OtherAssetsNoncurrent" order="1.2400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_Assets" order="1.2500" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_CashAndCashEquivalentsAtCarryingValue" order="1.2600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_RestrictedCashCurrent" order="1.2700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_HeldToMaturitySecuritiesCurrent" order="1.2800" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_AccountsReceivableNetCurrent" order="1.2900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_PrepaidExpenseCurrent" order="1.3000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_OtherAssetsCurrent" order="1.3100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_AssetsCurrent" order="1.3200" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_LiabilitiesCurrentAbstract" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_LongTermLineOfCredit" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="md_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscountedNoncurrent" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesNoncurrent" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_OtherLiabilitiesNoncurrent" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_Liabilities" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_CommitmentsAndContingencies" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_StockholdersEquityAbstract" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_LiabilitiesAndStockholdersEquity" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesCurrentAbstract" xlink:to="md_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent" order="1.3300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesCurrentAbstract" xlink:to="us-gaap_LongTermDebtAndCapitalLeaseObligationsCurrent" order="1.3400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesCurrentAbstract" xlink:to="us-gaap_AccruedIncomeTaxesCurrent" order="1.3500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesCurrentAbstract" xlink:to="us-gaap_LiabilitiesCurrent" order="1.3600" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_AssetsAbstract" order="1.1600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_LiabilitiesAndStockholdersEquityAbstract" order="1.1700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_PreferredStockValue" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_CommonStockValue" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_AdditionalPaidInCapitalCommonStock" order="1.1300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_RetainedEarningsAccumulatedDeficit" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_StockholdersEquity" order="1.1500" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassifiedParenthetical">
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_PreferredStockParOrStatedValuePerShare" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_PreferredStockSharesAuthorized" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_PreferredStockSharesIssued" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_CommonStockParOrStatedValuePerShare" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_CommonStockSharesAuthorized" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_CommonStockSharesIssued" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_CommonStockSharesOutstanding" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfIncomeAlternative">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DepreciationDepletionAndAmortization" xlink:label="us-gaap_DepreciationDepletionAndAmortization"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:label="us-gaap_EarningsPerShareAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareBasic" xlink:label="us-gaap_EarningsPerShareBasic"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract" xlink:label="us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareDiluted" xlink:label="us-gaap_EarningsPerShareDiluted"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeLossFromEquityMethodInvestments" xlink:label="us-gaap_IncomeLossFromEquityMethodInvestments"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeStatementAbstract" xlink:label="us-gaap_IncomeStatementAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InterestExpense" xlink:label="us-gaap_InterestExpense"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentIncomeNet" xlink:label="us-gaap_InvestmentIncomeNet"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLoss" xlink:label="us-gaap_NetIncomeLoss"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PracticeSalariesAndBenefits" xlink:label="md_PracticeSalariesAndBenefits"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PracticeSuppliesAndOtherOperatingExpenses" xlink:label="md_PracticeSuppliesAndOtherOperatingExpenses"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_EarningsPerShareBasic" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_EarningsPerShareDiluted" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_OperatingExpensesAbstract" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_OperatingIncomeLoss" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_InvestmentIncomeNet" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_InterestExpense" order="1.1300" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_IncomeLossFromEquityMethodInvestments" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_NonoperatingIncomeExpense" order="1.1500" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" order="1.1600" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="1.1700" preferredLabel="http://www.xbrl.org/2009/role/negatedTerseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_ProfitLoss" order="1.1800" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" order="1.1900" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_NetIncomeLoss" order="1.2000" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_EarningsPerShareAbstract" order="1.2100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract" order="1.2200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" order="1.2300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OperatingExpensesAbstract" xlink:to="md_PracticeSalariesAndBenefits" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OperatingExpensesAbstract" xlink:to="md_PracticeSuppliesAndOtherOperatingExpenses" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OperatingExpensesAbstract" xlink:to="us-gaap_GeneralAndAdministrativeExpense" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OperatingExpensesAbstract" xlink:to="us-gaap_DepreciationDepletionAndAmortization" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OperatingExpensesAbstract" xlink:to="us-gaap_OperatingExpenses" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfShareholdersEquityAndOtherComprehensiveIncome">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdditionalPaidInCapitalMember" xlink:label="us-gaap_AdditionalPaidInCapitalMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:label="us-gaap_EquityComponentDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NoncontrollingInterestMember" xlink:label="us-gaap_NoncontrollingInterestMember"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RetainedEarningsMember" xlink:label="us-gaap_RetainedEarningsMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharesIssued" xlink:label="us-gaap_SharesIssued"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharesIssued" xlink:label="us-gaap_SharesIssued_2"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementOfStockholdersEquityAbstract" xlink:label="us-gaap_StatementOfStockholdersEquityAbstract"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" xlink:label="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" xlink:label="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest_2"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration" xlink:label="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" xlink:label="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross" xlink:label="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_StockIssuedDuringPeriodSharesStockSwaps" xlink:label="md_StockIssuedDuringPeriodSharesStockSwaps"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration" xlink:label="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" xlink:label="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross" xlink:label="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_StockIssuedDuringPeriodValueStockSwaps" xlink:label="md_StockIssuedDuringPeriodValueStockSwaps"/>
    <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"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="1.2000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_AdditionalPaidInCapitalMember" order="1.2100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_RetainedEarningsMember" order="1.2200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_NoncontrollingInterestMember" order="1.2300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_SharesIssued" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ProfitLoss" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="md_StockIssuedDuringPeriodValueStockSwaps" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="md_StockIssuedDuringPeriodSharesStockSwaps" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" order="1.1300" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodValue" order="1.1500" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodShares" order="1.1600" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" order="1.1700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest_2" order="1.1800" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_SharesIssued_2" order="1.1900" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfStockholdersEquityAbstract" xlink:to="us-gaap_StatementTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfCashFlowsIndirect">
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalExpendituresIncurredButNotYetPaid" xlink:label="us-gaap_CapitalExpendituresIncurredButNotYetPaid"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeaseObligationsIncurred" xlink:label="us-gaap_CapitalLeaseObligationsIncurred"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract" xlink:label="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredIncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DepreciationDepletionAndAmortization" xlink:label="us-gaap_DepreciationDepletionAndAmortization"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities" xlink:label="us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxesPaidNet" xlink:label="us-gaap_IncomeTaxesPaidNet"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities" xlink:label="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccountsReceivable" xlink:label="us-gaap_IncreaseDecreaseInAccountsReceivable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable" xlink:label="us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve" xlink:label="us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:label="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInOtherNoncurrentAssets" xlink:label="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInOtherOperatingLiabilities" xlink:label="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets" xlink:label="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InterestPaidNet" xlink:label="us-gaap_InterestPaidNet"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivities"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PaymentsOfFinancingCosts" xlink:label="us-gaap_PaymentsOfFinancingCosts"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt" xlink:label="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensation" xlink:label="us-gaap_ShareBasedCompensation"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssued1" xlink:label="us-gaap_StockIssued1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SupplementalCashFlowInformationAbstract" xlink:label="us-gaap_SupplementalCashFlowInformationAbstract"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_DepreciationDepletionAndAmortization" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_AmortizationOfFinancingCostsAndDiscounts" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_ShareBasedCompensation" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_DeferredIncomeTaxExpenseBenefit" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_OtherNoncashIncomeExpense" order="1.0500" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract" xlink:to="us-gaap_StockIssued1" order="1.4600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract" xlink:to="us-gaap_CapitalLeaseObligationsIncurred" order="1.4700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract" xlink:to="us-gaap_CapitalExpendituresIncurredButNotYetPaid" order="1.4800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInAccountsReceivable" order="1.0600" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets" order="1.0700" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets" order="1.0800" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInAccruedIncomeTaxesPayable" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_PaymentForContingentConsiderationLiabilityOperatingActivities" order="1.1100" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInOtherOperatingLiabilities" order="1.1300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromLinesOfCredit" order="1.2500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_RepaymentsOfLinesOfCredit" order="1.2600" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt" order="1.2700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_PaymentsOfFinancingCosts" order="1.2800" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_PaymentForContingentConsiderationLiabilityFinancingActivities" order="1.2900" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_RepaymentsOfLongTermCapitalLeaseObligations" order="1.3000" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities" order="1.3100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromIssuanceOfCommonStock" order="1.3200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromMinorityShareholders" order="1.3300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_PaymentsForRepurchaseOfCommonStock" order="1.3400" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivities" order="1.3500" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired" order="1.1800" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsToAcquireInvestments" order="1.1900" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromSaleMaturityAndCollectionsOfInvestments" order="1.2000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsToAcquireOtherPropertyPlantAndEquipment" order="1.2100" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets" order="1.2200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsForProceedsFromOtherInvestingActivities" order="1.2300" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivities" order="1.2400" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_ProfitLoss" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" order="1.1500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" order="1.1600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivities" order="1.1700" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" order="1.3600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" order="1.3700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" order="1.3800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" order="1.3900" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" order="1.4000" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_2" order="1.4100" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_SupplementalCashFlowInformationAbstract" order="1.4200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract" order="1.4300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SupplementalCashFlowInformationAbstract" xlink:to="us-gaap_InterestPaidNet" order="1.4400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SupplementalCashFlowInformationAbstract" xlink:to="us-gaap_IncomeTaxesPaidNet" order="1.4500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="us-gaap_AccountingPoliciesAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableMember" xlink:label="us-gaap_AccountsReceivableMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BuildingMember" xlink:label="us-gaap_BuildingMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_BusinessCombinationContingentConsiderationArrangementsTimePeriod" xlink:label="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized" xlink:label="us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_CashAndCashEquivalentsMaturityDescription" xlink:label="md_CashAndCashEquivalentsMaturityDescription"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashSurrenderValueFairValueDisclosure" xlink:label="us-gaap_CashSurrenderValueFairValueDisclosure"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ComputerEquipmentMember" xlink:label="us-gaap_ComputerEquipmentMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByTypeAxis" xlink:label="us-gaap_ConcentrationRiskByTypeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:label="us-gaap_ConcentrationRiskPercentage1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskTypeDomain" xlink:label="us-gaap_ConcentrationRiskTypeDomain"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquipmentMember" xlink:label="us-gaap_EquipmentMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_EquityMethodInvesteeNameDomain" xlink:label="srt_EquityMethodInvesteeNameDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityMethodInvestmentOwnershipPercentage" xlink:label="us-gaap_EquityMethodInvestmentOwnershipPercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FurnitureAndFixturesMember" xlink:label="us-gaap_FurnitureAndFixturesMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GovernmentContractsConcentrationRiskMember" xlink:label="us-gaap_GovernmentContractsConcentrationRiskMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_LongTermInvestmentsMaturityPeriod" xlink:label="md_LongTermInvestmentsMaturityPeriod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_MoneyMarketFundsAtFairValue" xlink:label="md_MoneyMarketFundsAtFairValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:label="us-gaap_PropertyPlantAndEquipmentUsefulLife"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:label="srt_RangeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis" xlink:label="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ShortTermInvestmentMaturityPeriod" xlink:label="md_ShortTermInvestmentMaturityPeriod"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" xlink:label="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SoftwareAndSoftwareDevelopmentCostsMember" xlink:label="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:label="md_SummaryOfSignificantAccountingPoliciesLineItems"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SummaryOfSignificantAccountingPoliciesTable" xlink:label="md_SummaryOfSignificantAccountingPoliciesTable"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_UnnamedCorporateJointVentureMember" xlink:label="md_UnnamedCorporateJointVentureMember"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="md_SummaryOfSignificantAccountingPoliciesTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="us-gaap_AccountsReceivableMember" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:to="us-gaap_ConcentrationRiskBenchmarkDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByTypeAxis" xlink:to="us-gaap_ConcentrationRiskTypeDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_GovernmentContractsConcentrationRiskMember" order="1.1500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" order="1.1800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" order="1.2100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_EquityMethodInvesteeNameDomain" xlink:to="md_UnnamedCorporateJointVentureMember" order="1.1300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_BuildingMember" order="1.1700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_EquipmentMember" order="1.2000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_ComputerEquipmentMember" order="1.2200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_SoftwareAndSoftwareDevelopmentCostsMember" order="1.2300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_FurnitureAndFixturesMember" order="1.2400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="1.1600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="1.1900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis" xlink:to="srt_EquityMethodInvesteeNameDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_EquityMethodInvestmentOwnershipPercentage" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_ConcentrationRiskPercentage1" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_CashAndCashEquivalentsMaturityDescription" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_LongTermInvestmentsMaturityPeriod" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_ShortTermInvestmentMaturityPeriod" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentUsefulLife" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_BusinessCombinationContingentConsiderationArrangementsTimePeriod" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetUsefulLife" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="md_MoneyMarketFundsAtFairValue" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_CashSurrenderValueFairValueDisclosure" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_DebtInstrumentInterestRateStatedPercentage" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="srt_RangeAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis" order="11.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_ConcentrationRiskByTypeAxis" order="12.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_ConcentrationRiskByBenchmarkAxis" order="13.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis" order="14.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_CreditFacilityAxis" order="15.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_SummaryOfSignificantAccountingPoliciesTable" xlink:to="md_SummaryOfSignificantAccountingPoliciesLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AnesthesiologyMember" xlink:label="md_AnesthesiologyMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByTypeAxis" xlink:label="us-gaap_ConcentrationRiskByTypeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:label="us-gaap_ConcentrationRiskPercentage1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskTypeDomain" xlink:label="us-gaap_ConcentrationRiskTypeDomain"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_MaternalFetalMedicineMember" xlink:label="md_MaternalFetalMedicineMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NeonatologyAndOtherPediatricSubspecialtiesMember" xlink:label="md_NeonatologyAndOtherPediatricSubspecialtiesMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PediatricCardiologyMember" xlink:label="md_PediatricCardiologyMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProductConcentrationRiskMember" xlink:label="us-gaap_ProductConcentrationRiskMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductOrServiceAxis" xlink:label="srt_ProductOrServiceAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:label="srt_ProductsAndServicesDomain"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_RadiologyAndTeleradiologyMember" xlink:label="md_RadiologyAndTeleradiologyMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_RegulatoryAssetsAbstract" xlink:label="md_RegulatoryAssetsAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SalesRevenueServicesNetMember" xlink:label="us-gaap_SalesRevenueServicesNetMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" xlink:label="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SegmentReportingInformationLineItems" xlink:label="us-gaap_SegmentReportingInformationLineItems"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="us-gaap_SalesRevenueServicesNetMember" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:to="us-gaap_ConcentrationRiskBenchmarkDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByTypeAxis" xlink:to="us-gaap_ConcentrationRiskTypeDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_ProductConcentrationRiskMember" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_NeonatologyAndOtherPediatricSubspecialtiesMember" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_AnesthesiologyMember" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_RadiologyAndTeleradiologyMember" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_MaternalFetalMedicineMember" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="us-gaap_ManagementServiceMember" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_PediatricCardiologyMember" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_RegulatoryAssetsAbstract" xlink:to="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" xlink:to="us-gaap_ConcentrationRiskByTypeAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" xlink:to="us-gaap_ConcentrationRiskByBenchmarkAxis" order="11.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" xlink:to="srt_ProductOrServiceAxis" order="12.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTable" xlink:to="us-gaap_SegmentReportingInformationLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SegmentReportingInformationLineItems" xlink:to="us-gaap_ConcentrationRiskPercentage1" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfInvestments">
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HeldToMaturitySecuritiesNoncurrent" xlink:label="us-gaap_HeldToMaturitySecuritiesNoncurrent"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/invest/2013/invest-2013-01-31.xsd#invest_InvestmentsScheduleAbstract" xlink:label="invest_InvestmentsScheduleAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentTypeAxis" xlink:label="us-gaap_InvestmentTypeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentTypeCategorizationMember" xlink:label="us-gaap_InvestmentTypeCategorizationMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems" xlink:label="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems"/>
    <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"/>
    <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"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="invest_InvestmentsScheduleAbstract" xlink:to="us-gaap_ScheduleOfHeldToMaturitySecuritiesTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentTypeAxis" xlink:to="us-gaap_InvestmentTypeCategorizationMember" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_USStatesAndPoliticalSubdivisionsMember" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_USGovernmentSponsoredEnterprisesDebtSecuritiesMember" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_CertificatesOfDepositMember" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems" xlink:to="us-gaap_HeldToMaturitySecuritiesCurrent" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems" xlink:to="us-gaap_HeldToMaturitySecuritiesNoncurrent" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfHeldToMaturitySecuritiesTable" xlink:to="us-gaap_InvestmentTypeAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfHeldToMaturitySecuritiesTable" xlink:to="us-gaap_ScheduleOfHeldToMaturitySecuritiesLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments">
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HeldToMaturitySecuritiesNoncurrent" xlink:label="us-gaap_HeldToMaturitySecuritiesNoncurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_HeldToMaturitySecuritiesNoncurrent" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableGrossCurrent" xlink:label="us-gaap_AccountsReceivableGrossCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableNetCurrent" xlink:label="us-gaap_AccountsReceivableNetCurrent"/>
    <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"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ReceivablesAbstract" xlink:to="us-gaap_AccountsReceivableGrossCurrent" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ReceivablesAbstract" xlink:to="us-gaap_AllowanceForDoubtfulAccountsReceivableCurrent" order="1.0200" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ReceivablesAbstract" xlink:to="us-gaap_AccountsReceivableNetCurrent" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsNotesLoansAndFinancingReceivableGrossAllowanceAndNetAbstract" xlink:label="us-gaap_AccountsNotesLoansAndFinancingReceivableGrossAllowanceAndNetAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisaggregationOfRevenueAbstract" xlink:label="us-gaap_DisaggregationOfRevenueAbstract"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_HospitalsContractsMember" xlink:label="md_HospitalsContractsMember"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductOrServiceAxis" xlink:label="srt_ProductOrServiceAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:label="srt_ProductsAndServicesDomain"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ScheduleOfFinancingReceivablesLineItems" xlink:label="md_ScheduleOfFinancingReceivablesLineItems"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountsNotesLoansAndFinancingReceivableGrossAllowanceAndNetAbstract" xlink:to="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisaggregationOfRevenueAbstract" xlink:to="us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="us-gaap_HealthCarePatientServiceMember" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="md_HospitalsContractsMember" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="us-gaap_ManagementServiceMember" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable" xlink:to="srt_ProductOrServiceAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTable" xlink:to="md_ScheduleOfFinancingReceivablesLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_ScheduleOfFinancingReceivablesLineItems" xlink:to="us-gaap_DisaggregationOfRevenueAbstract" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ContractedManagedCareMember" xlink:label="md_ContractedManagedCareMember"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:label="us-gaap_HealthCareOrganizationRevenueSourcesDomain"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PercentageOfNetPatientServiceRevenueByTypeOfPayor" xlink:label="md_PercentageOfNetPatientServiceRevenueByTypeOfPayor"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable" xlink:label="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SelfPayMember" xlink:label="us-gaap_SelfPayMember"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems" xlink:to="md_PercentageOfNetPatientServiceRevenueByTypeOfPayor" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_HealthCareOrganizationRevenueAndExpenseAbstract" xlink:to="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesAxis" xlink:to="us-gaap_HealthCareOrganizationRevenueSourcesDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:to="md_ContractedManagedCareMember" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:to="us-gaap_GovernmentMember" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:to="us-gaap_ThirdPartyPayorMember" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:to="us-gaap_SelfPayMember" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable" xlink:to="us-gaap_HealthCareOrganizationRevenueSourcesAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable" xlink:to="us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableNetCurrent" xlink:label="us-gaap_AccountsReceivableNetCurrent"/>
    <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"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ReceivablesAbstract" xlink:to="us-gaap_AccountsReceivableNetCurrent" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ReceivablesAbstract" xlink:to="us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BuildingsAndImprovementsGross" xlink:label="us-gaap_BuildingsAndImprovementsGross"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FixturesAndEquipmentGross" xlink:label="us-gaap_FixturesAndEquipmentGross"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Land" xlink:label="us-gaap_Land"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentAbstract" xlink:label="us-gaap_PropertyPlantAndEquipmentAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentGross" xlink:label="us-gaap_PropertyPlantAndEquipmentGross"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentAbstract" xlink:to="us-gaap_BuildingsAndImprovementsGross" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentAbstract" xlink:to="us-gaap_Land" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentAbstract" xlink:to="us-gaap_FixturesAndEquipmentGross" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentGross" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentAbstract" xlink:to="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" order="1.0500" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentNet" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosurePropertyAndEquipmentAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Depreciation" xlink:label="us-gaap_Depreciation"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" xlink:label="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract" xlink:label="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentGross" xlink:label="us-gaap_PropertyPlantAndEquipmentGross"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentLineItems" xlink:label="us-gaap_PropertyPlantAndEquipmentLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:label="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_PropertyPlantAndEquipmentCapitalizedInterestCostsAbstract" xlink:to="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentGross" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_Depreciation" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:to="us-gaap_PropertyPlantAndEquipmentLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureBusinessAcquisitionsAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup" xlink:label="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionAcquireeDomain" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionAxis" xlink:label="us-gaap_BusinessAcquisitionAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:label="us-gaap_BusinessAcquisitionLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationConsiderationTransferred1" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1" xlink:label="us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:label="us-gaap_BusinessCombinationsAbstract"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DeconsolidationPercentage" xlink:label="md_DeconsolidationPercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityMethodInvestmentOwnershipPercentage" xlink:label="us-gaap_EquityMethodInvestmentOwnershipPercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAcquiredDuringPeriod" xlink:label="us-gaap_GoodwillAcquiredDuringPeriod"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfMaternalfetalMedicinePracticesAcquired" xlink:label="md_NumberOfMaternalfetalMedicinePracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfNeonatologyPracticesAcquired" xlink:label="md_NumberOfNeonatologyPracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfPediatricMultiSpecialtyPracticesAcquired" xlink:label="md_NumberOfPediatricMultiSpecialtyPracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfPediatricSubspecialtyPracticesAcquired" xlink:label="md_NumberOfPediatricSubspecialtyPracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfPhysicianGroupPracticesAcquired" xlink:label="md_NumberOfPhysicianGroupPracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NumberOfRadiologyPracticesAcquired" xlink:label="md_NumberOfRadiologyPracticesAcquired"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions" xlink:label="md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PaymentsToAcquireBusinessesGross" xlink:label="us-gaap_PaymentsToAcquireBusinessesGross"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PhysicianGroupMember" xlink:label="md_PhysicianGroupMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PriorPeriodAcquisitionsMember" xlink:label="md_PriorPeriodAcquisitionsMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SaleOfMinorityInterestPercentage" xlink:label="md_SaleOfMinorityInterestPercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:to="md_PhysicianGroupMember" order="1.2300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:to="md_PriorPeriodAcquisitionsMember" order="1.2400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="us-gaap_BusinessAcquisitionAcquireeDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfPhysicianGroupPracticesAcquired" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfNeonatologyPracticesAcquired" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfPediatricSubspecialtyPracticesAcquired" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfRadiologyPracticesAcquired" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationConsiderationTransferred1" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_GoodwillAcquiredDuringPeriod" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_PaymentsForPreviousAcquisition" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets" order="1.1300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_GoodwillPurchaseAccountingAdjustments" order="1.1500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_PaymentsToAcquireBusinessesGross" order="1.1600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_AssetsHeldForSaleNotPartOfDisposalGroup" order="1.1700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_EquityMethodInvestmentOwnershipPercentage" order="1.1800" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfMaternalfetalMedicinePracticesAcquired" order="1.1900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_NumberOfPediatricMultiSpecialtyPracticesAcquired" order="1.2000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_SaleOfMinorityInterestPercentage" order="1.2100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="md_DeconsolidationPercentage" order="1.2200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" xlink:label="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AmortizationOfIntangibleAssets" xlink:label="us-gaap_AmortizationOfIntangibleAssets"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount" xlink:label="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:label="us-gaap_BusinessCombinationsAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FinitelivedIntangibleAssetsAcquired1" xlink:label="us-gaap_FinitelivedIntangibleAssetsAcquired1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:label="md_GoodwillAndOtherIntangibleAssetsLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillPeriodIncreaseDecrease" xlink:label="us-gaap_GoodwillPeriodIncreaseDecrease"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ManagementServicesReportingUnitMember" xlink:label="md_ManagementServicesReportingUnitMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PhysicianAndHospitalAgreementsMember" xlink:label="md_PhysicianAndHospitalAgreementsMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SegmentDomain" xlink:label="us-gaap_SegmentDomain"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="md_PhysicianAndHospitalAgreementsMember" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_Goodwill" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_GoodwillPeriodIncreaseDecrease" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_FinitelivedIntangibleAssetsAcquired1" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_GoodwillAndOtherIntangibleAssetsLineItems" xlink:to="us-gaap_AmortizationOfIntangibleAssets" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_StatementBusinessSegmentsAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" order="11.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="md_GoodwillAndOtherIntangibleAssetsLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SegmentDomain" xlink:to="md_ManagementServicesReportingUnitMember" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementBusinessSegmentsAxis" xlink:to="us-gaap_SegmentDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CustomerRelationshipsMember" xlink:label="us-gaap_CustomerRelationshipsMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsGross" xlink:label="us-gaap_FiniteLivedIntangibleAssetsGross"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:label="us-gaap_FiniteLivedIntangibleAssetsLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PatentedAndOtherTechnologyMember" xlink:label="md_PatentedAndOtherTechnologyMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PhysicianAndHospitalAgreementsMember" xlink:label="md_PhysicianAndHospitalAgreementsMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TradeNamesMember" xlink:label="us-gaap_TradeNamesMember"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsGross" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" order="1.0600" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsNet" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="md_PhysicianAndHospitalAgreementsMember" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="us-gaap_CustomerRelationshipsMember" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="us-gaap_TradeNamesMember" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="md_PatentedAndOtherTechnologyMember" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableCurrent" xlink:label="us-gaap_AccountsPayableCurrent"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccruedContingentConsiderationLiabilityCurrent" xlink:label="md_AccruedContingentConsiderationLiabilityCurrent"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccruedPayrollTaxesAndBenefitsCurrent" xlink:label="md_AccruedPayrollTaxesAndBenefitsCurrent"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InterestPayableCurrent" xlink:label="us-gaap_InterestPayableCurrent"/>
    <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"/>
    <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"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccountsPayableCurrent" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccruedSalariesCurrent" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="md_AccruedPayrollTaxesAndBenefitsCurrent" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="md_AccruedContingentConsiderationLiabilityCurrent" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_InterestPayableCurrent" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_OtherAccruedLiabilitiesCurrent" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrent" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesAdditionalInformation">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccruedProfessionalLiability" xlink:label="md_AccruedProfessionalLiability"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InsuranceSettlementsReceivable" xlink:label="us-gaap_InsuranceSettlementsReceivable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyAccrualUndiscounted" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SelfInsuranceReserveCurrent" xlink:label="us-gaap_SelfInsuranceReserveCurrent"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscounted" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_SelfInsuranceReserveCurrent" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="md_AccruedProfessionalLiability" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_InsuranceSettlementsReceivable" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition" xlink:label="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyAccrualUndiscounted" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyAccrualUndiscounted" xlink:label="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyClaimsIncurredNet" xlink:label="us-gaap_MalpracticeLossContingencyClaimsIncurredNet"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_MalpracticeLossContingencyProvisionForLosses" xlink:label="md_MalpracticeLossContingencyProvisionForLosses"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ProvisionAdjustmentForLossesRelatedToCurrentYear" xlink:label="md_ProvisionAdjustmentForLossesRelatedToCurrentYear"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ProvisionAdjustmentForLossesRelatedToPriorYear" xlink:label="md_ProvisionAdjustmentForLossesRelatedToPriorYear"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscounted" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="md_ProvisionAdjustmentForLossesRelatedToCurrentYear" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="md_ProvisionAdjustmentForLossesRelatedToPriorYear" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="md_MalpracticeLossContingencyProvisionForLosses" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod" order="1.0600" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods" order="1.0700" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_MalpracticeLossContingencyClaimsIncurredNet" order="1.0800" preferredLabel="http://www.xbrl.org/2009/role/negatedTotalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscounted_2" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AlternateBaseRateMember" xlink:label="md_AlternateBaseRateMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ApplicableMarginRateMember" xlink:label="md_ApplicableMarginRateMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ChangeInControlMember" xlink:label="md_ChangeInControlMember"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:label="us-gaap_DebtDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentAxis" xlink:label="us-gaap_DebtInstrumentAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" xlink:label="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentDescriptionOfVariableRateBasis" xlink:label="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentFaceAmount" xlink:label="us-gaap_DebtInstrumentFaceAmount"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentLineItems" xlink:label="us-gaap_DebtInstrumentLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentMaturityDateDescription" xlink:label="us-gaap_DebtInstrumentMaturityDateDescription"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentMaturityYear" xlink:label="md_DebtInstrumentMaturityYear"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentNameDomain" xlink:label="us-gaap_DebtInstrumentNameDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodAxis" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodAxis"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember" xlink:label="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodFiveMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodFiveMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodFourMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodFourMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodOneMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodOneMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentRedemptionPeriodSixAndThereafterMember" xlink:label="md_DebtInstrumentRedemptionPeriodSixAndThereafterMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember" xlink:label="md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodThreeMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodThreeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPeriodTwoMember" xlink:label="us-gaap_DebtInstrumentRedemptionPeriodTwoMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPricePercentage" xlink:label="us-gaap_DebtInstrumentRedemptionPricePercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed" xlink:label="us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FederalFundsEffectiveSwapRateMember" xlink:label="us-gaap_FederalFundsEffectiveSwapRateMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LetterOfCreditMember" xlink:label="us-gaap_LetterOfCreditMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LettersOfCreditOutstandingAmount" xlink:label="us-gaap_LettersOfCreditOutstandingAmount"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityCommitmentFeePercentage" xlink:label="us-gaap_LineOfCreditFacilityCommitmentFeePercentage"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityExpirationDate1" xlink:label="us-gaap_LineOfCreditFacilityExpirationDate1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" xlink:label="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity" xlink:label="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityTable" xlink:label="us-gaap_LineOfCreditFacilityTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LondonInterbankOfferedRateLIBORMember" xlink:label="us-gaap_LondonInterbankOfferedRateLIBORMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LongTermDebt" xlink:label="us-gaap_LongTermDebt"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherOwnershipInterestsByNameAxis" xlink:label="us-gaap_OtherOwnershipInterestsByNameAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherOwnershipInterestsNameDomain" xlink:label="us-gaap_OtherOwnershipInterestsNameDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:label="srt_RangeMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" xlink:label="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioUnspecifiedDomain" xlink:label="us-gaap_ScenarioUnspecifiedDomain"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" xlink:label="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementScenarioAxis" xlink:label="us-gaap_StatementScenarioAxis"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_UnsecuredRevolvingCreditFacilityMember" xlink:label="md_UnsecuredRevolvingCreditFacilityMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_VariableRateAxis" xlink:label="us-gaap_VariableRateAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_VariableRateDomain" xlink:label="us-gaap_VariableRateDomain"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_UnsecuredRevolvingCreditFacilityMember" order="1.1500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="us-gaap_LetterOfCreditMember" order="1.2200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" order="1.2700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" order="1.2900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_LineOfCreditFacilityTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentAxis" xlink:to="us-gaap_DebtInstrumentNameDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LineOfCreditFacilityExpirationDate1" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentDescriptionOfVariableRateBasis" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LineOfCreditFacilityCommitmentFeePercentage" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentFaceAmount" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentInterestRateStatedPercentage" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentMaturityDateDescription" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentRedemptionPricePercentage" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="md_DebtInstrumentMaturityYear" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LongTermDebt" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LettersOfCreditOutstandingAmount" order="1.1300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="md_AlternateBaseRateMember" order="1.1600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="md_ApplicableMarginRateMember" order="1.2400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodAxis" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodOneMember" order="1.1900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodTwoMember" order="1.2600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember" order="1.2800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember" order="1.3000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodThreeMember" order="1.3100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodFourMember" order="1.3200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodFiveMember" order="1.3300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentRedemptionPeriodDomain" xlink:to="md_DebtInstrumentRedemptionPeriodSixAndThereafterMember" order="1.3400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_CreditFacilityAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_DebtInstrumentAxis" order="11.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_VariableRateAxis" order="12.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_DebtInstrumentRedemptionPeriodAxis" order="13.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_OtherOwnershipInterestsByNameAxis" order="14.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="srt_RangeAxis" order="15.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_StatementScenarioAxis" order="16.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_DebtInstrumentLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OtherOwnershipInterestsByNameAxis" xlink:to="us-gaap_OtherOwnershipInterestsNameDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OtherOwnershipInterestsNameDomain" xlink:to="md_ChangeInControlMember" order="1.2100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="1.1800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="1.2500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScenarioUnspecifiedDomain" xlink:to="md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember" order="1.2000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementScenarioAxis" xlink:to="us-gaap_ScenarioUnspecifiedDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_VariableRateDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateDomain" xlink:to="us-gaap_FederalFundsEffectiveSwapRateMember" order="1.1700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateDomain" xlink:to="us-gaap_LondonInterbankOfferedRateLIBORMember" order="1.2300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt">
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:label="us-gaap_DebtDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentCarryingAmount" xlink:label="us-gaap_DebtInstrumentCarryingAmount"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentLineItems" xlink:label="us-gaap_DebtInstrumentLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentTable" xlink:label="us-gaap_DebtInstrumentTable"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LongTermDebt" xlink:label="us-gaap_LongTermDebt"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevolvingCreditFacilityMember" xlink:label="us-gaap_RevolvingCreditFacilityMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnamortizedDebtIssuanceExpense" xlink:label="us-gaap_UnamortizedDebtIssuanceExpense"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="us-gaap_RevolvingCreditFacilityMember" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_DebtInstrumentTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentCarryingAmount" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_UnamortizedDebtIssuanceExpense" order="1.0200" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LongTermDebt" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_CreditFacilityAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_DebtInstrumentLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes">
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentFairValueDisclosureAbstract" xlink:label="us-gaap_DebtInstrumentFairValueDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentFairValueLineItems" xlink:label="md_DebtInstrumentFairValueLineItems"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DebtInstrumentFairValueTable" xlink:label="md_DebtInstrumentFairValueTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EstimateOfFairValueFairValueDisclosureMember" xlink:label="us-gaap_EstimateOfFairValueFairValueDisclosureMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:label="us-gaap_FairValueByFairValueHierarchyLevelAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueByMeasurementBasisAxis" xlink:label="us-gaap_FairValueByMeasurementBasisAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueDisclosureItemAmountsDomain" xlink:label="us-gaap_FairValueDisclosureItemAmountsDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueInputsLevel2Member" xlink:label="us-gaap_FairValueInputsLevel2Member"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:label="us-gaap_FairValueMeasurementsFairValueHierarchyDomain"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:label="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PortionAtFairValueFairValueDisclosureMember" xlink:label="us-gaap_PortionAtFairValueFairValueDisclosureMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" xlink:label="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentFairValueDisclosureAbstract" xlink:to="md_DebtInstrumentFairValueTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DebtInstrumentFairValueLineItems" xlink:to="us-gaap_NotesPayableFairValueDisclosure" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DebtInstrumentFairValueTable" xlink:to="us-gaap_CreditFacilityAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DebtInstrumentFairValueTable" xlink:to="us-gaap_FairValueByFairValueHierarchyLevelAxis" order="11.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DebtInstrumentFairValueTable" xlink:to="us-gaap_FairValueByMeasurementBasisAxis" order="12.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_DebtInstrumentFairValueTable" xlink:to="md_DebtInstrumentFairValueLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:to="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueByMeasurementBasisAxis" xlink:to="us-gaap_FairValueDisclosureItemAmountsDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosureItemAmountsDomain" xlink:to="us-gaap_PortionAtFairValueFairValueDisclosureMember" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosureItemAmountsDomain" xlink:to="us-gaap_EstimateOfFairValueFairValueDisclosureMember" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:to="us-gaap_FairValueInputsLevel2Member" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeaseObligations" xlink:label="us-gaap_CapitalLeaseObligations"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeaseObligationsCurrent" xlink:label="us-gaap_CapitalLeaseObligationsCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeaseObligationsNoncurrent" xlink:label="us-gaap_CapitalLeaseObligationsNoncurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:label="us-gaap_DebtDisclosureAbstract"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_CapitalLeaseObligations" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_CapitalLeaseObligationsCurrent" order="1.0200" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_CapitalLeaseObligationsNoncurrent" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears" xlink:label="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:label="us-gaap_DebtDisclosureAbstract"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CurrentFederalTaxExpenseBenefit" xlink:label="us-gaap_CurrentFederalTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CurrentStateAndLocalTaxExpenseBenefit" xlink:label="us-gaap_CurrentStateAndLocalTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredFederalIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredFederalIncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" xlink:label="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations" xlink:label="us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="us-gaap_IncomeTaxDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations" xlink:label="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_CurrentFederalTaxExpenseBenefit" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredFederalIncomeTaxExpenseBenefit" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_CurrentStateAndLocalTaxExpenseBenefit" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet" xlink:label="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ChangeInAccountingEstimateByTypeAxis" xlink:label="us-gaap_ChangeInAccountingEstimateByTypeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ChangeInAccountingEstimateTypeDomain" xlink:label="us-gaap_ChangeInAccountingEstimateTypeDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DeferredTaxLiabilitiesChangeInAccountingMethod" xlink:label="md_DeferredTaxLiabilitiesChangeInAccountingMethod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarliestTaxYearMember" xlink:label="us-gaap_EarliestTaxYearMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:label="us-gaap_EffectiveIncomeTaxRateContinuingOperations"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="us-gaap_IncomeTaxDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued" xlink:label="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability" xlink:label="us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncomeTaxExpenseForExcessTaxDeficiencies" xlink:label="md_IncomeTaxExpenseForExcessTaxDeficiencies"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncomeTaxLineItems" xlink:label="md_IncomeTaxLineItems"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncomeTaxTable" xlink:label="md_IncomeTaxTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInDeferredLiabilities" xlink:label="us-gaap_IncreaseDecreaseInDeferredLiabilities"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:label="md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" xlink:label="md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_InterestAndPenaltiesMember" xlink:label="md_InterestAndPenaltiesMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_InternalRevenueCodeSection481Member" xlink:label="md_InternalRevenueCodeSection481Member"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LatestTaxYearMember" xlink:label="us-gaap_LatestTaxYearMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:label="srt_MinimumMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NetOperatingLossCarryForwardsExpirationDate" xlink:label="md_NetOperatingLossCarryForwardsExpirationDate"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OpenTaxYear" xlink:label="us-gaap_OpenTaxYear"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLossCarryforwards" xlink:label="us-gaap_OperatingLossCarryforwards"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:label="srt_RangeMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis" xlink:label="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioForecastMember" xlink:label="us-gaap_ScenarioForecastMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioUnspecifiedDomain" xlink:label="us-gaap_ScenarioUnspecifiedDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain" xlink:label="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementScenarioAxis" xlink:label="us-gaap_StatementScenarioAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxPeriodAxis" xlink:label="us-gaap_TaxPeriodAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxPeriodDomain" xlink:label="us-gaap_TaxPeriodDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefits" xlink:label="us-gaap_UnrecognizedTaxBenefits"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate" xlink:label="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease" xlink:label="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate" xlink:label="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ChangeInAccountingEstimateByTypeAxis" xlink:to="us-gaap_ChangeInAccountingEstimateTypeDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ChangeInAccountingEstimateTypeDomain" xlink:to="md_InternalRevenueCodeSection481Member" order="1.2100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="md_IncomeTaxTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_EffectiveIncomeTaxRateContinuingOperations" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_IncreaseDecreaseInDeferredLiabilities" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="md_DeferredTaxLiabilitiesChangeInAccountingMethod" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="md_IncomeTaxExpenseForExcessTaxDeficiencies" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_OperatingLossCarryforwards" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="md_NetOperatingLossCarryForwardsExpirationDate" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration" order="1.1300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefits" order="1.1500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate" order="1.1600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease" order="1.1700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="1.1800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued" order="1.1900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxLineItems" xlink:to="us-gaap_OpenTaxYear" order="1.2000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxTable" xlink:to="srt_RangeAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxTable" xlink:to="us-gaap_StatementScenarioAxis" order="11.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxTable" xlink:to="us-gaap_ChangeInAccountingEstimateByTypeAxis" order="12.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxTable" xlink:to="us-gaap_TaxPeriodAxis" order="13.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxTable" xlink:to="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis" order="14.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_IncomeTaxTable" xlink:to="md_IncomeTaxLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="1.2200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="1.2600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis" xlink:to="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScenarioUnspecifiedDomain" xlink:to="us-gaap_ScenarioForecastMember" order="1.2300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SignificantChangeInUnrecognizedTaxBenefitsIsReasonablyPossibleNatureOfUncertaintyDomain" xlink:to="md_InterestAndPenaltiesMember" order="1.2400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementScenarioAxis" xlink:to="us-gaap_ScenarioUnspecifiedDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TaxPeriodAxis" xlink:to="us-gaap_TaxPeriodDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TaxPeriodDomain" xlink:to="us-gaap_EarliestTaxYearMember" order="1.2500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TaxPeriodDomain" xlink:to="us-gaap_LatestTaxYearMember" order="1.2700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:label="us-gaap_EffectiveIncomeTaxRateContinuingOperations"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="us-gaap_IncomeTaxDisclosureAbstract"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateContinuingOperations" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredIncomeTaxLiabilities" xlink:label="us-gaap_DeferredIncomeTaxLiabilities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsGross" xlink:label="us-gaap_DeferredTaxAssetsGross"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsNet" xlink:label="us-gaap_DeferredTaxAssetsNet"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOther" xlink:label="us-gaap_DeferredTaxAssetsOther"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment" xlink:label="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsValuationAllowance" xlink:label="us-gaap_DeferredTaxAssetsValuationAllowance"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilities" xlink:label="us-gaap_DeferredTaxLiabilities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesAbstract" xlink:label="us-gaap_DeferredTaxLiabilitiesAbstract"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_DeferredTaxLiabilitiesChangeInAccountingMethod" xlink:label="md_DeferredTaxLiabilitiesChangeInAccountingMethod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" xlink:label="us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" xlink:label="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesOther" xlink:label="us-gaap_DeferredTaxLiabilitiesOther"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="us-gaap_IncomeTaxDisclosureAbstract"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" order="1.0100" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesAbstract" xlink:to="md_DeferredTaxLiabilitiesChangeInAccountingMethod" order="1.0200" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals" order="1.0300" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesOther" order="1.0400" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesAbstract" xlink:to="us-gaap_DeferredIncomeTaxLiabilities" order="1.0500" preferredLabel="http://www.xbrl.org/2009/role/negatedTotalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxAssetsOther" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxAssetsGross" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxAssetsValuationAllowance" order="1.1300" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxAssetsNet" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesAbstract" order="1.1500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxLiabilities" order="1.1600" preferredLabel="http://www.xbrl.org/2009/role/negatedTotalLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="us-gaap_IncomeTaxDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefits" xlink:label="us-gaap_UnrecognizedTaxBenefits"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefits" xlink:label="us-gaap_UnrecognizedTaxBenefits_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions" xlink:label="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities" xlink:label="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions" xlink:label="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions" xlink:label="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations" xlink:label="us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_UnrecognizedTaxBenefits" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions" order="1.0300" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities" order="1.0500" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations" order="1.0600" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_UnrecognizedTaxBenefits_2" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare">
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:label="us-gaap_EarningsPerShareAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" xlink:label="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AmendedAndRestatedTwoThousandEightPlanMember" xlink:label="md_AmendedAndRestatedTwoThousandEightPlanMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:label="us-gaap_AwardTypeAxis"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockOptionMember" xlink:label="us-gaap_EmployeeStockOptionMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember" xlink:label="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation" xlink:label="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:label="srt_RangeMember"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_RestrictedAndDeferredStockUnitsMember" xlink:label="md_RestrictedAndDeferredStockUnitsMember"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:label="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember" xlink:label="md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameAxis" xlink:to="us-gaap_PlanNameDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameDomain" xlink:to="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember" order="1.1800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameDomain" xlink:to="md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember" order="1.2000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameDomain" xlink:to="md_AmendedAndRestatedTwoThousandEightPlanMember" order="1.2100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameDomain" xlink:to="md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember" order="1.2300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="1.1700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_PlanNameAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_AwardTypeAxis" order="11.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="srt_RangeAxis" order="12.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_CommonStockSharesAuthorized" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_AllocatedShareBasedCompensationExpense" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" order="1.1300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation" order="1.1500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_EmployeeStockOptionMember" order="1.1600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockMember" order="1.1900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="md_RestrictedAndDeferredStockUnitsMember" order="1.2200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod" order="1.0300" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod" order="1.0400" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_2" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_2" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice_2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" xlink:label="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" order="1.0400" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber_2" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice_2" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" order="1.1300" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommonStockRepurchaseProgramsAdditionalInformation">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AcceleratedShareRepurchaseAgreementsMember" xlink:label="md_AcceleratedShareRepurchaseAgreementsMember"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt" xlink:label="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:label="us-gaap_AwardTypeAxis"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_CommonStockLineItems" xlink:label="md_CommonStockLineItems"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_CommonStockTable" xlink:label="md_CommonStockTable"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityAbstract" xlink:label="us-gaap_EquityAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:label="us-gaap_EquityComponentDomain"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareRepurchaseProgramAxis" xlink:label="us-gaap_ShareRepurchaseProgramAxis"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareRepurchaseProgramDomain" xlink:label="us-gaap_ShareRepurchaseProgramDomain"/>
    <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"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockRepurchaseProgramAuthorizedAmount1" xlink:label="us-gaap_StockRepurchaseProgramAuthorizedAmount1"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_StockRepurchaseProgramAuthorizedAmount1" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodValue" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_StockRepurchasedDuringPeriodShares" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_CommonStockLineItems" xlink:to="us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_CommonStockTable" xlink:to="us-gaap_ShareRepurchaseProgramAxis" order="10.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_CommonStockTable" xlink:to="us-gaap_AwardTypeAxis" order="11.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_CommonStockTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="12.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="md_CommonStockTable" xlink:to="md_CommonStockLineItems" order="100.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityAbstract" xlink:to="md_CommonStockTable" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockMember" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareRepurchaseProgramAxis" xlink:to="us-gaap_ShareRepurchaseProgramDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareRepurchaseProgramDomain" xlink:to="md_AcceleratedShareRepurchaseAgreementsMember" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="1.0000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureRetirementPlansAdditionalInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:label="us-gaap_CompensationAndRetirementDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DefinedContributionPlanCostRecognized" xlink:label="us-gaap_DefinedContributionPlanCostRecognized"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:to="us-gaap_DefinedContributionPlanCostRecognized" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesAdditionalInformation">
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LeaseAndRentalExpense" xlink:label="us-gaap_LeaseAndRentalExpense"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_LeaseAndRentalExpense" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases">
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDue"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDue" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DepreciationDepletionAndAmortization" xlink:label="us-gaap_DepreciationDepletionAndAmortization"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareBasic" xlink:label="us-gaap_EarningsPerShareBasic"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareDiluted" xlink:label="us-gaap_EarningsPerShareDiluted"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeLossFromEquityMethodInvestments" xlink:label="us-gaap_IncomeLossFromEquityMethodInvestments"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:label="us-gaap_IncomeTaxExpenseBenefit"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InterestExpense" xlink:label="us-gaap_InterestExpense"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentIncomeNet" xlink:label="us-gaap_InvestmentIncomeNet"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLoss" xlink:label="us-gaap_NetIncomeLoss"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest"/>
    <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"/>
    <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"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PracticeSalariesAndBenefits" xlink:label="md_PracticeSalariesAndBenefits"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_PracticeSuppliesAndOtherOperatingExpenses" xlink:label="md_PracticeSuppliesAndOtherOperatingExpenses"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="md_PracticeSalariesAndBenefits" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="md_PracticeSuppliesAndOtherOperatingExpenses" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_GeneralAndAdministrativeExpense" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_DepreciationDepletionAndAmortization" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_OperatingExpenses" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_OperatingIncomeLoss" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_InvestmentIncomeNet" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_InterestExpense" order="1.0900" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_IncomeLossFromEquityMethodInvestments" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_NonoperatingIncomeExpense" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="1.1300" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_ProfitLoss" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" order="1.1500" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_NetIncomeLoss" order="1.1600" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_EarningsPerShareBasic" order="1.1700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_EarningsPerShareDiluted" order="1.1800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" order="1.1900" preferredLabel="http://www.xbrl.org/2003/role/positiveLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" order="1.2000" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsNatureOfOperations">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NatureOfOperations" xlink:label="us-gaap_NatureOfOperations"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_NatureOfOperations" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="us-gaap_AccountingPoliciesAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SignificantAccountingPoliciesTextBlock" xlink:label="us-gaap_SignificantAccountingPoliciesTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_SignificantAccountingPoliciesTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="us-gaap_AccountingPoliciesAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsPolicy" xlink:label="us-gaap_BusinessCombinationsPolicy"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsPolicyTextBlock" xlink:label="us-gaap_CashAndCashEquivalentsPolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy" xlink:label="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_CommonStockShareRepurchasesPolicyTextBlock" xlink:label="md_CommonStockShareRepurchasesPolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConsolidationPolicyTextBlock" xlink:label="us-gaap_ConsolidationPolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerSharePolicyTextBlock" xlink:label="us-gaap_EarningsPerSharePolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueOfFinancialInstrumentsPolicy" xlink:label="us-gaap_FairValueOfFinancialInstrumentsPolicy"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock" xlink:label="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock" xlink:label="us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxPolicyTextBlock" xlink:label="us-gaap_IncomeTaxPolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentPolicyTextBlock" xlink:label="us-gaap_InvestmentPolicyTextBlock"/>
    <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"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ProfessionalLiabilityCoveragePolicyTextBlock" xlink:label="md_ProfessionalLiabilityCoveragePolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock" xlink:label="md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueRecognitionPolicyTextBlock" xlink:label="us-gaap_RevenueRecognitionPolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SegmentReportingPolicyPolicyTextBlock" xlink:label="us-gaap_SegmentReportingPolicyPolicyTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy" xlink:label="us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UseOfEstimates" xlink:label="us-gaap_UseOfEstimates"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ConsolidationPolicyTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_UseOfEstimates" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_SegmentReportingPolicyPolicyTextBlock" order="1.0500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_RevenueRecognitionPolicyTextBlock" order="1.0600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_CashAndCashEquivalentsPolicyTextBlock" order="1.0700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy" order="1.0800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_InvestmentPolicyTextBlock" order="1.0900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" order="1.1000" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_BusinessCombinationsPolicy" order="1.1100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock" order="1.1200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock" order="1.1300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="md_CommonStockShareRepurchasesPolicyTextBlock" order="1.1400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="md_ProfessionalLiabilityCoveragePolicyTextBlock" order="1.1500" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_IncomeTaxPolicyTextBlock" order="1.1600" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy" order="1.1700" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_EarningsPerSharePolicyTextBlock" order="1.1800" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_FairValueOfFinancialInstrumentsPolicy" order="1.1900" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:label="us-gaap_AccountingPoliciesAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfSegmentReportingInformationBySegmentTextBlock" xlink:label="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ScheduleOfSegmentReportingInformationBySegmentTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" xlink:label="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HeldToMaturitySecuritiesTextBlock" xlink:label="us-gaap_HeldToMaturitySecuritiesTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock" xlink:label="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_HeldToMaturitySecuritiesTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_AccountsReceivableAndNetRevenueDisclosureTextBlock" xlink:label="md_AccountsReceivableAndNetRevenueDisclosureTextBlock"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TextBlockAbstract" xlink:to="md_AccountsReceivableAndNetRevenueDisclosureTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisaggregationOfRevenueTableTextBlock" xlink:label="us-gaap_DisaggregationOfRevenueTableTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock" xlink:label="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock" xlink:label="us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TextBlockAbstract" xlink:to="us-gaap_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TextBlockAbstract" xlink:to="us-gaap_DisaggregationOfRevenueTableTextBlock" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TextBlockAbstract" xlink:to="us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentAbstract" xlink:label="us-gaap_PropertyPlantAndEquipmentAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentAbstract" xlink:label="us-gaap_PropertyPlantAndEquipmentAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTextBlock" xlink:label="us-gaap_PropertyPlantAndEquipmentTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationDisclosureTextBlock" xlink:label="us-gaap_BusinessCombinationDisclosureTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:label="us-gaap_BusinessCombinationsAbstract"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_BusinessCombinationDisclosureTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables">
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock" xlink:label="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HealthCareOrganizationsAbstract" xlink:label="us-gaap_HealthCareOrganizationsAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_MalpracticeLossContingencyDisclosureTextBlock" xlink:label="us-gaap_MalpracticeLossContingencyDisclosureTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_HealthCareOrganizationsAbstract" xlink:to="us-gaap_MalpracticeLossContingencyDisclosureTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HealthCareOrganizationsAbstract" xlink:label="us-gaap_HealthCareOrganizationsAbstract"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock" xlink:label="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_HealthCareOrganizationsAbstract" xlink:to="md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock" xlink:label="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:label="us-gaap_DebtDisclosureAbstract"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:label="us-gaap_DebtDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_ScheduleOfCapitalLeaseObligationsTableTextBlock" xlink:label="md_ScheduleOfCapitalLeaseObligationsTableTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfDebtTableTextBlock" xlink:label="us-gaap_ScheduleOfDebtTableTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock" xlink:label="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock"/>
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_SummaryOfEstimatedFairValueOfNotesTableTextBlock" xlink:label="md_SummaryOfEstimatedFairValueOfNotesTableTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_ScheduleOfDebtTableTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="md_SummaryOfEstimatedFairValueOfNotesTableTextBlock" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="md_ScheduleOfCapitalLeaseObligationsTableTextBlock" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="us-gaap_IncomeTaxDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureTextBlock" xlink:label="us-gaap_IncomeTaxDisclosureTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_IncomeTaxDisclosureTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:label="us-gaap_IncomeTaxDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" xlink:label="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" xlink:label="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" xlink:label="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SummaryOfIncomeTaxContingenciesTextBlock" xlink:label="us-gaap_SummaryOfIncomeTaxContingenciesTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" order="1.0300" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_SummaryOfIncomeTaxContingenciesTextBlock" order="1.0400" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:label="us-gaap_EarningsPerShareAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareTextBlock" xlink:label="us-gaap_EarningsPerShareTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_EarningsPerShareTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlockTables">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:label="us-gaap_EarningsPerShareAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock" xlink:label="us-gaap_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock" xlink:label="us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" xlink:label="us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" order="1.0200" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommonStockRepurchasesTextBlock">
    <loc xlink:type="locator" xlink:href="md-20181231.xsd#md_CommonStockRepurchasesTextBlock" xlink:label="md_CommonStockRepurchasesTextBlock"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TextBlockAbstract" xlink:to="md_CommonStockRepurchasesTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:label="us-gaap_CompensationAndRetirementDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" xlink:label="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:to="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock">
    <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"/>
    <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"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables">
    <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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" xlink:label="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_QuarterlyFinancialInformationTextBlock" xlink:label="us-gaap_QuarterlyFinancialInformationTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_QuarterlyFinancialInformationTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
  <presentationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables">
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock" xlink:label="us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock"/>
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock" order="1.0100" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" priority="2" use="optional"/>
  </presentationLink>
</linkbase>
</XBRL>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>GRAPHIC
<SEQUENCE>17
<FILENAME>g671465g65b88.jpg
<DESCRIPTION>GRAPHIC
<TEXT>
begin 644 g671465g65b88.jpg
M_]C_X1 217AI9@  34T *@    @ #0$   ,    ! EX   $!  ,    ! 5X
M  $"  ,    #    J@$&  ,    !  (   $2  ,    !  $   $5  ,    !
M  ,   $:  4    !    L $;  4    !    N $H  ,    !  ,   $Q  (
M   >    P $R  (    4    W@$[  (    )    \H=I  0    !    _
M 30 "  (  @ .:V@   G$  YK:   "<0061O8F4@4&AO=&]S:&]P($-3-B H
M5VEN9&]W<RD ,C Q.3HP,CHQ,R P-CHP,CHS, !S:VIB;W-C;P    20   '
M    !# R,C&@ 0 #     ?__  "@ @ $     0   F:@ P $     0   68
M        !@$#  ,    !  8   $:  4    !   !@@$;  4    !   !B@$H
M  ,    !  (   (!  0    !   !D@("  0    !   .>         !(
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M-:S98W^V^ZOU/]'3_-UNR[K)N8'XM#:=P%I&98YVTENZRO\ 0,_F_?\ H_\
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M #BE-O@W[S_<E-O@W[S_ ')*5Z8\7?YQ2],>+O\ .*4V^#?O/]R4V^#?O/\
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M=^@J_P Q6?TOBW[BE^E\6_<4E-;]E8/YM99_4>]O_4/:I.Z=CNY??\LBX?\
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M+3 Q.$))300E       0GQ-/!(!B-V(Z*)+XHJQ2Y#A"24T$.@      ]P
M !     !       +<')I;G1/=71P=70    %     %!S=%-B;V]L 0    !)
M;G1E96YU;0    !);G1E     $-L<FT    /<')I;G13:7AT965N0FET8F]O
M;      +<')I;G1E<DYA;65415A4    "@!( %  +0!& %  1P M #0 ,
M    #W!R:6YT4')O;V93971U<$]B:F,    , %  <@!O &\ 9@ @ %, 90!T
M '4 <       "G!R;V]F4V5T=7     !     $)L=&YE;G5M    #&)U:6QT
M:6Y0<F]O9@    EP<F]O9D--64L .$))300[      (M    $     $
M !)P<FEN=$]U='!U=$]P=&EO;G,    7     $-P=&YB;V]L      !#;&)R
M8F]O;       4F=S36)O;VP      $-R;D-B;V]L      !#;G1#8F]O;
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M(%5N=$8C4')C0%D            08W)O<%=H96Y0<FEN=&EN9V)O;VP
M#F-R;W!296-T0F]T=&]M;&]N9P         ,8W)O<%)E8W1,969T;&]N9P
M       -8W)O<%)E8W12:6=H=&QO;F<         "V-R;W!296-T5&]P;&]N
M9P      .$))30/M       0 \ >N  "  $#P!ZX  (  3A"24T$)@
M#@             _@   .$))300-       $    'CA"24T$&0      !
M !XX0DE- _,       D           $ .$))32<0       *  $
M 3A"24T#]0      2  O9F8  0!L9F8 !@       0 O9F8  0"AF9H !@
M     0 R     0!:    !@       0 U     0 M    !@       3A"24T#
M^       <   _____________________________P/H     /__________
M__________________\#Z     #_____________________________ ^@
M    _____________________________P/H   X0DE-! @      !     !
M   "0    D      .$))300>       $     #A"24T$&@     #00    8
M             68   )F    !@!G #8 -0!B #@ .     $
M             0             "9@   68                      0
M                       0     0       &YU;&P    "    !F)O=6YD
M<T]B:F,    !        4F-T,0    0     5&]P(&QO;F<          $QE
M9G1L;VYG          !"=&]M;&]N9P   68     4F=H=&QO;F<   )F
M!G-L:6-E<U9L3',    !3V)J8P    $       5S;&EC90   !(    '<VQI
M8V5)1&QO;F<         !V=R;W5P241L;VYG          9O<FEG:6YE;G5M
M    #$53;&EC94]R:6=I;@    UA=71O1V5N97)A=&5D     %1Y<&5E;G5M
M    "D53;&EC951Y<&4     26UG(     9B;W5N9'-/8FIC     0
M %)C=#$    $     %1O<"!L;VYG          !,969T;&]N9P
M0G1O;6QO;F<   %F     %)G:'1L;VYG   "9@    -U<FQ415A4     0
M     &YU;&Q415A4     0       $US9V5415A4     0      !F%L=%1A
M9U1%6%0    !       .8V5L;%1E>'1)<TA434QB;V]L 0    AC96QL5&5X
M=%1%6%0    !       ):&]R>D%L:6=N96YU;0    ]%4VQI8V5(;W)Z06QI
M9VX    '9&5F875L=     EV97)T06QI9VYE;G5M    #T53;&EC959E<G1!
M;&EG;@    =D969A=6QT    "V)G0V]L;W)4>7!E96YU;0   !%%4VQI8V5"
M1T-O;&]R5'EP90    !.;VYE    "71O<$]U='-E=&QO;F<         "FQE
M9G1/=71S971L;VYG          QB;W1T;VU/=71S971L;VYG          MR
M:6=H=$]U='-E=&QO;F<      #A"24T$*       #     (_\        #A"
M24T$$0       0$ .$))3004       $     3A"24T$#      .E     $
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M9_Z33#-I)(#;9'/Z&WOK_HT^93?=068]YQK.U@:'?YS'?^25,]-ZJ:GM'5;
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M]*+/%OW'^])3-0L^C\Q^4)19XM^X_P!Z9X?&I$2.!Y_%)3__V3A"24T$(0
M    50    $!    #P!! &0 ;P!B &4 ( !0 &@ ;P!T &\ <P!H &\ <
M !, 00!D &\ 8@!E "  4 !H &\ = !O ', : !O '  ( !# %, -@    $
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M P,# P,# P,# P,# P,# P,# P,# P/_P  1" %F F8# 1$  A$! Q$!_]T
M! !-_\0!H@    8" P$             !P@&!00) PH" 0 + 0  !@,! 0$
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M#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\
MM#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7N
MO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_
M\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]
M#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\
MM#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7N
MO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_
M\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]
M#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\
MM#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7N
MO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_
M\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]
M#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\
MM#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7N
MO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_
M\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]
M#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\
MM#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7N
MO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_
M\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]
M#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\
MM#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7N
MO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_
M\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]
M#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\
MM#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7N
MO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]#[L;_P"T-[]U[KW^G?,_
M\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\ M#>_=>Z]_IWS/_.HZW_]
M#[L;_P"T-[]U[KW^G?,_\ZCK?_T/NQO_ +0WOW7NO?Z=\S_SJ.M__0^[&_\
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M  [;&*SN;7(_PZ@7<E:K1T%2\GVE88Y##*XC<K[KU#Z'IKJ/YC?P/I.G<?\
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M<_\ SWW6'_HHMU__ &[O?NO=>_A/<_\ SWW6'_HHMU__ &[??NO=>_A/<_\
MSWW6'_HHMU__ &[O?NO=>_A/<_\ SWW6'_HHMU__ &[O?NO=>_A/<_\ SWW6
M'_HHMU__ &[??NO=>_A/<_\ SWW6'_HHMU__ &[O?NO=>_A/<_\ SWW6'_HH
MMU__ &[1[]U[KW\)[G_Y[[K#_P!%%NO_ .W=[]U[KW\)[G_Y[[K#_P!%%NO_
M .W;[]U[KW\)[G_Y[[K#_P!%%NO_ .W=[]U[KW\)[G_Y[[K#_P!%%NO_ .W=
M[]U[KW\)[G_Y[[K#_P!%%NO_ .W=[]U[KW\)[G_Y[[K#_P!%%NO_ .W=[]U[
MKW\)[G_Y[[K#_P!%%NO_ .W;[]U[KW\)[G_Y[[K#_P!%%NO_ .W=[]U[KW\)
M[G_Y[[K#_P!%%NO_ .W=[]U[KW\)[G_Y[[K#_P!%%NO_ .W=[]U[KW\)[G_Y
M[[K#_P!%%NO_ .W;[]U[KW\)[G_Y[[K#_P!%%NO_ .W=[]U[KW\)[G_Y[[K#
M_P!%%NO_ .W=[]U[KW\)[G_Y[[K#_P!%%NO_ .W;[]U[KW\)[G_Y[[K#_P!%
M%NO_ .W=[]U[KW\)[G_Y[[K#_P!%%NO_ .W;[]U[KW\)[G_Y[[K#_P!%%NO_
M .W;[]U[KPQ/<_\ SWW6'_HHMU_['_FMOOW7NO?PGN?_ )[[K#_T46Z__MW>
M_=>Z]_">Y_\ GONL/_11;K_^W=[]U[KW\)[G_P">^ZP_]%%NO_[=W]/?NO=>
M_A/<_P#SWW6'_HHMU_\ V[??NO=>_A/<_P#SWW6'_HHMU_\ V[O?NO=>_A/<
M_P#SWW6'_HHMU_\ V[O?NO=>_A/<_P#SWW6'_HHMU_\ V[??NO=>_A/<_P#S
MWW6'_HH]U_[V>[O?NO==#$]T?\]_UA_Z*+=?_P!N[W[KW7?\)[G_ .>^ZP_]
M%%NO_P"W=[]U[KW\)[G_ .>^ZP_]%%NO_P"W=[]U[KW\)[G_ .>^ZP_]%%NO
M_>O]-WOW7NO?PGN?_GONL/\ T46Z_P#[=WOW7NO?PGN?_GONL/\ T46Z_P#[
M=WOW7NO?PGN?_GONL/\ T46Z_P#[=OOW7NO?PGN?_GONL/\ T46Z_P#[=WOW
M7NO?PGN?_GONL/\ T46Z_P#[=OOW7NO'$]S_ //?=8?^BBW5_P#;M_I[]U[K
MW\)[G_Y[[K#_ -%%NO\ ^W=[]U[KW\)[G_Y[[K#_ -%%NO\ ^W;[]U[KW\)[
MG_Y[[K#_ -%%NO\ ^W=[]U[KW\)[G_Y[[K#_ -%%NO\ ^W=[]U[KW\)[G_Y[
M[K#_ -%%NO\ ^W;[]U[KW\)[G_Y[[K#_ -%%NO\ ^W;[]U[KW\)[G_Y[[K#_
M -%%NO\ ^W=[]U[KW\)[G_Y[[K#_ -%%NO\ ^W;[]U[KW\)[G_Y[[K#_ -%%
MNO\ ^W=[]U[KW\)[G_Y[[K#_ -%%NO\ ^W=[]U[KW\)[G_Y[[K#_ -%%NO\
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MZ][]U[KWOW7NO>_=>Z][]U[HLG_-*_\ RYO_ .?*]^ZMY_E_DZ__UMZG+?\
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MW[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW19/\
MFE?_ )<W_P#/E>_=6\_R_P G7__1WJ<M_P SGV#_ .(P[=_]ZOI'W[KW0G^_
M=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[HD^W?^WC?<7_BD_P ;
M?_?Z_*SW[K?D.CL>_=:Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[K
MWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=
M>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KW
MOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>
MZ][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWO
MW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z
M][]U[KWOW7NO>_=>Z][]U[KWOW7NBR?\TK_\N;_^?*]^ZMY_E_DZ_]+>IRW_
M #.?8/\ XC#MW_WJ^D??NO="?[]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][
M]U[KWOW7NB3[=_[>-]Q?^*3_ !M_]_K\K/?NM^0Z.Q[]UKKWOW7NO>_=>Z][
M]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7N
MO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]
MU[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO
M>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U
M[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>
M_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z+)_S2
MO_RYO_Y\KW[JWG^7^3K_T]ZG+?\ ,Y]@_P#B,.W?_>KZ1]^Z]T)_OW7NO>_=
M>Z][]U[KWOW7NL1G@$ZTQFB%2\3SI3F1!.T$;I'),L5_(T222JI:U@6 )Y'O
MW7NLOOW7NO>_=>Z][]U[HD^W?^WC?<7_ (I/\;?_ '^ORL]^ZWY#H['OW6NO
M>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U
M[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>
M_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[
MKWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_
M=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[K
MWOW7NL%354U%"]365$%+31Z?)45,T<$$>MUC37+*R(NN1PHN>20/?NO=>J*J
MFI(UEJZB"FC>>FI4DJ)8X4>IK:B*CHZ='E95:>KJYTBB2^J21U5020#[KW6?
MW[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]T63_FE?_ES?
M_P ^5[]U;S_+_)U__]3>IRW_ #.?8/\ XC#MW_WJ^D??NO="?[]U[KWOW7NO
M>_=>Z][]U[K4>[3[.V7U]_.1JMQ9GNW*=DUN[/DS%U13UFR>W]_]3_(;XIUM
M;U=US12[*W7T;O[$Y'K?M[XBXG$BHW'-DL32TU#/#D:_)S5-3-C3;W3@^#HG
M6/[<ZZRO4/RQ[!^&ORJWG2?'RGZQ^/\ U;VMC]X_*[([Y^6G?6#7YG]3X/Y(
M?/?L+KC';OKMQ_'K;LO6NYLCMUJMJ7!U]5A\W)6ST>.@%(@]U;30BHHW\OET
M+$6[^K*[O6DZ6WYW7E:'^4YB?F'\^<5UYNZ?O[>6-ZLEW'LKX?\ 1&[^O-DX
M7N.+?%/59?:VT^RMP;XR&VJ,9B>DESU/-'3B26G6)?=:IC [J#_5_@ZV6/Y6
MVZNT]\?RZOACN[NJNSN5[-W#\>^NLGN7,;H>IFW)F_N,' V&SN>J:TM75N8S
M>WQ25=343EIZB:9I9"7=B?=4>FIJ<*]1S5[PI?YC':YVC@=MYR1_A3\<Q7+N
M+=>3VLE,B]Z?*C[=J1\;LS>#5K2L7UAU@"!18OJ(7W6O(=&O_BW<W_/ =9?^
MC<W3_P#:4]^ZUU[^+=S?\\!UE_Z-S=/_ -I3W[KW7OXMW-_SP'67_HW-T_\
MVE/?NO=>_BW<W_/ =9?^C<W3_P#:4]^Z]U[^+=S?\\!UE_Z-S=/_ -I3W[KW
M7OXMW-_SP'67_HW-T_\ VE/?NO=>_BW<W_/ =9?^C<W3_P#:4]^Z]U[^+=S?
M\\!UE_Z-S=/_ -I3W[KW7OXMW-_SP'67_HW-T_\ VE/?NO=>_BW<W_/ =9?^
MC<W3_P#:4]^Z]U[^+=S?\\!UE_Z-S=/_ -I3W[KW7OXMW-_SP'67_HW-T_\
MVE/?NO=>_BW<W_/ =9?^C<W3_P#:4]^Z]U[^+=S?\\!UE_Z-S=/_ -I3W[KW
M7OXMW-_SP'67_HW-T_\ VE/?NO=>_BW<W_/ =9?^C<W3_P#:4]^Z]U[^+=S?
M\\!UE_Z-S=/_ -I3W[KW7OXMW-_SP'67_HW-T_\ VE/?NO=>_BW<W_/ =9?^
MC<W3_P#:4]^Z]U[^+=S?\\!UE_Z-S=/_ -I3W[KW7OXMW-_SP'67_HW-T_\
MVE/?NO=>_BW<W_/ =9?^C<W3_P#:4]^Z]U[^+=S?\\!UE_Z-S=/_ -I3W[KW
M7OXMW-_SP'67_HW-T_\ VE/?NO=>_BW<W_/ =9?^C<W3_P#:4]^Z]U[^+=S?
M\\!UE_Z-S=/_ -I3W[KW7OXMW-_SP'67_HW-T_\ VE/?NO=>_BW<W_/ =9?^
MC<W3_P#:4]^Z]U[^+=S?\\!UE_Z-S=/_ -I3W[KW7OXMW-_SP'67_HW-T_\
MVE/?NO=>_BW<W_/ =9?^C<W3_P#:4]^Z]U[^+=S?\\!UE_Z-S=/_ -I3W[KW
M7OXMW-_SP'67_HW-T_\ VE/?NO=>_BW<W_/ =9?^C<W3_P#:4]^Z]U[^+=S?
M\\!UE_Z-S=/_ -I3W[KW7OXMW-_SP'67_HW-T_\ VE/?NO=>_BW<W_/ =9?^
MC<W3_P#:4]^Z]U[^+=S?\\!UE_Z-S=/_ -I3W[KW7OXMW-_SP'67_HW-T_\
MVE/?NO=>_BW<W_/ =9?^C<W3_P#:4]^Z]U[^+=S?\\!UE_Z-S=/_ -I3W[KW
M7OXMW-_SP'67_HW-T_\ VE/?NO=>_BW<W_/ =9?^C<W3_P#:4]^Z]U[^+=S?
M\\!UE_Z-S=/_ -I3W[KW7OXMW-_SP'67_HW-T_\ VE/?NO=>_BW<W_/ =9?^
MC<W3_P#:4]^Z]U[^+=S?\\!UE_Z-S=/_ -I3W[KW7OXMW-_SP'67_HW-T_\
MVE/?NO=>_BW<W_/ =9?^C<W3_P#:4]^Z]U[^+=S?\\!UE_Z-S=/_ -I3W[KW
M7OXMW/\ \\!UE_Z-S=/_ -I3W[KW77\7[G_YX#K+_P!&YNG_ (CI3W[KW39F
M-Y=F[=QU1E]P;7Z>P6)HT\E7E,QW7GL9CJ5/]745M;TS!30)Q]68#W[KW1)N
MP?YJOQ7ZQK?X3NSY'?"L[@\C0_W4VK\IY^P=Y&=;_L+LWK_I_<^Z6G;2=*"C
MU,0; V]^ZV%8\!T'/_#L&2W,;](?"WY3?(JF?BGR_6W3/R VCM>LDY]%+O3Y
M ]"=);-F%_[?\0\9!#!M)!]^ZW3U(Z:N[?E1\P]X='=C3=B?RP=E;$Z8K-CY
MQ>R*GYA?+?K'%;87:510RQ92++;)Z%V7\CMTYU:J%_%%CXHH,C43ND<$9G,:
MGW7@!4=W^K^71<_ACBOEAB]Q_&C+?S2\!7TW7,N3@@^%> CW'GM[8+JGM+*[
MDS$76F*^7F1W)@,/NO.][OM&LQV-ZVSN?$T=).)*7*>#>U33S5GNO-IKV];$
M?OW5>O>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[HLG_-*_P#R
MYO\ ^?*]^ZMY_E_DZ__5WJ<M_P SGV#_ .(P[=_]ZOI'W[KW0G^_=>Z][]U[
MKWOW7NO>_=>Z0U5UEUY6[XB[+J]D[8J>P(=N5VT8]X3X6@EW -L9*:FGK\&V
M2>$U,F.J9*2/5&S$:05%E9@?=>ZRX_K;KO$BO7%;"V7C%RN.J<1E!C]K8.C&
M2Q-:%%9BZ\4]#&*S'581?+!)JBDL-2GW[KW6*;K'K:IVI1[$J.O=CS[(QTL4
M^/V=-M/ 2[5H9X*B2K@FH]O/CVQ%++#5RM*C)"I61BPL23[]UZN:^?2W5515
M1%5$10JJH"JJJ+*JJ+ *H%@!]/?NO=$IV[_V\;[B_P#%)_C;_P"_U^5GOW6_
M(='8]^ZUU[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U
M[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW7O?N
MO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[
MW[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW7O?NO
M=>]^Z]U[W[KW2$S79VPMN;\V5UCGMT8W#[Z['Q^Z<GL/;V1::DJ-VP;*BQ=3
MNFGP-3-$N/R.5PU#F(:J6ACF-::,2U"Q-!3SR1^Z]UWANS=A;BWYO3K'!;GQ
MN7WUUSCMK93?>WL<TU74;2I]ZQ92IVM!G:F&)J#'Y3,T.'FJHJ&285HHS%4-
M$L%1!))[KW4[>&_=B]>8MLWO_>FT]CX5-9?+[PW%A]M8Q @U/JK\U645*NA3
M<^O@>_=>X\.B.[K_ )L?\N+:>4DP1^7W4.]]P1ZE?;?3&5R'?FY1(ITM -N]
M(8SL'--4J_I,0@,@;C3?CW[JVEOX3TFO^'+Z3=/IZ2^#W\PONQ:CC%Y>E^--
M9T?M3(ZQ^S4IN/Y3[EZ)A7'27YG2*6P_LDBWOW7M/J1_J^SKW^G?^:+OO_)]
MB? +I/IF.;U1YWY,_,?'U]52)QQ4;+^.G5';]/4SZ3?2FX8TU#3K .L>Z]11
M^+KK_1)_->W_ .O>/S(^*G0=)]/X7\?_ (G[H[&S@1K$_P"_W[V[IKL,:B+D
M"3^Z@C;B\0YO[KU5_A_GUW_PW3O'=W^4=W?S$_Y@G:%3/_Q<<;M/MO97QKVK
M4 \204N*^,?6G4^=HZ647#(<M*2O&KZW]U[5Z*!_J^?3GAOY1?\ +IH,C3YG
M<?QCVKV[FZ=_*,U\B=Q[_P#DKDY9SS)//4]^;M[&,DDK<L+!/P !8>_=:U'R
M/1VNONGNI.I:+^&]5]6]<]9X[QK#]AU_LC;.S*+Q+;3%]KMS&8V#QK;A=-A[
M]UKCQZ$;W[KW7O\ ??D>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][
M]U[KWOW7NO>_=>Z][]U[HLG_ #2O_P N;_\ GRO?NK>?Y?Y.O__6WJ<M_P S
MGV#_ .(P[=_]ZOI'W[KW0G^_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>
MZ][]U[HD^W?^WC?<7_BD_P ;?_?Z_*SW[K?D.CL>_=:Z][]U[KWOW7NO>_=>
MZ][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWO
MW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z
M][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW
M7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z);WW_,"^+WQZW/#UKN
M+?%;V!WE7Q%\'\<^C=N9KNGO[-N51H5CZPZ^I,UGL#1U&OTY#,KC,6H!+U*
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M?[=?_/D>S_\ S[=,?_;=]^Z]U[^_VZ_^?(]G_P#GVZ8_^V[[]U[KW]_MU_\
M/D>S_P#S[=,?_;=]^Z]U[^_VZ_\ GR/9_P#Y]NF/_MN^_=>Z]_?[=?\ SY'L
M_P#\^W3'_P!MWW[KW7O[_;K_ .?(]G_^?;IC_P"V[[]U[KW]_MU_\^1[/_\
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M^_VZ_P#GR/9__GVZ8_\ MN^_=>Z]_?[=?_/D>S__ #[=,?\ VW??NO=>_O\
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ML/Y[[1J$YGK.O<-\>_D!@44?5H:CJ'OS<&XZG^H5,3K(_ /'OW7J#R8==_\
M#M?Q PO[7:47R4Z$K1_G:3O7X;?*SKFGIP/U//N')]/R[22-?]7_ !#21R"1
MS[]U[0QX4_:.A+V+_,X_EV=D2)3;/^;WQ;R&0D;0F%KN[=@;?W"9+Z3&=N;C
MSF)SJNK<%33@@\'GW[KVEOX3T</;6\=H[SH5RFS]T[<W9C'"E<CMK-XS.T+!
MA=2M7BZJJIR&'T]7/OW5>E%[]U[KOW[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z
M]U[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW7O?NO=%D_YI7_Y<W_\
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M \.KAO?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW19/\
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M_=>Z][]U[KWOW7NBR?\ -*__ "YO_P"?*]^ZMY_E_DZ__]+>IRW_ #.?8/\
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M=>_TN[4_YU/9_P#Z)'N?_P"P'W[KW7O]+NU/^=3V?_Z)'N?_ .P'W[KW7O\
M2[M3_G4]G_\ HD>Y_P#[ ??NO=>_TN[4_P"=3V?_ .B1[G_^P'W[KW7O]+NU
M/^=3V?\ ^B1[G_\ L!]^Z]U[_2[M3_G4]G_^B1[G_P#L!]^Z]U[_ $N[4_YU
M/9__ *)'N?\ ^P'W[KW7O]+NU/\ G4]G_P#HD>Y__L!]^Z]U[_2[M3_G4]G_
M /HD>Y__ + ??NO=>_TN[4_YU/9__HD>Y_\ [ ??NO=>_P!+NU/^=3V?_P"B
M1[G_ /L!]^Z]U[_2[M3_ )U/9_\ Z)'N?_[ ??NO=>_TN[4_YU/9_P#Z)'N?
M_P"P'W[KW7O]+NU/^=3V?_Z)'N?_ .P'W[KW7O\ 2[M3_G4]G_\ HD>Y_P#[
M ??NO=>_TN[4_P"=3V?_ .B1[G_^P'W[KW7O]+NU/^=3V?\ ^B1[G_\ L!]^
MZ]U[_2[M3_G4]G_^B1[G_P#L!]^Z]U[_ $N[4_YU/9__ *)'N?\ ^P'W[KW7
MO]+NU/\ G4]G_P#HD>Y__L!]^Z]U[_2[M3_G4]G_ /HD>Y__ + ??NO=>_TN
M[4_YU/9__HD>Y_\ [ ??NO=>_P!+NU/^=3V?_P"B1[G_ /L!]^Z]U[_2[M3_
M )U/9_\ Z)'N?_[ ??NO=>_TN[4_YU/9_P#Z)'N?_P"P'W[KW7O]+NU/^=3V
M?_Z)'N?_ .P'W[KW7O\ 2[M3_G4]G_\ HD>Y_P#[ ??NO=>_TN[4_P"=3V?_
M .B1[G_^P'W[KW7O]+NU/^=3V?\ ^B1[G_\ L!]^Z]U[_2[M3_G4]G_^B1[G
M_P#L!]^Z]U[_ $N[4_YU/9__ *)'N?\ ^P'W[KW7O]+NU/\ G4]G_P#HD>Y_
M_L!]^Z]U[_2[M3_G4]G_ /HD>Y__ + ??NO=>_TN[4_YU/9__HD>Y_\ [ ??
MNO=>_P!+NU/^=3V?_P"B1[G_ /L!]^Z]U[_2[M3_ )U/9_\ Z)'N?_[ ??NO
M=>_TN[4_YU/9_P#Z)'N?_P"P'W[KW7O]+NU/^=3V?_Z)'N?_ .P'W[KW7O\
M2[M3_G4]G_\ HD>Y_P#[ ??NO=>_TN[4_P"=3V?_ .B1[G_^P'W[KW7O]+NU
M/^=3V?\ ^B1[G_\ L!]^Z]U[_2[M3_G4]G_^B1[G_P#L!]^Z]U[_ $N[4_YU
M/9__ *)'N?\ ^P'W[KW7O]+NU/\ G4]G_P#HD>Y__L!]^Z]U[_2[M3_G4]G_
M /HD>Y__ + ??NO=>_TN[4_YU/9__HD>Y_\ [ ??NO=>_P!+NU/^=3V?_P"B
M1[G_ /L!]^Z]U[_2[M3_ )U/9_\ Z)'N?_[ ??NO=>_TN[4_YU/9_P#Z)'N?
M_P"P'W[KW7O]+NU/^=3V?_Z)'N?_ .P'W[KW7O\ 2[M3_G4]G_\ HD>Y_P#[
M ??NO=>_TN[4_P"=3V?_ .B1[G_^P'W[KW7O]+NU/^=3V?\ ^B1[G_\ L!]^
MZ]U[_2[M3_G4]G_^B1[G_P#L!]^Z]U#R/9FQ,OCZ[$Y;;?8>4Q64HZK'9/&9
M'HCN&MQ^1Q]; ]-64-=1U/7TM-5T=732M'+%(K)(C%6!!(]^Z]TB>O?C_P#%
MBFKL?O;8/QNZGV=G<%DB^(SJ_'S"]<;IQ61IHXW6NQ+YC9&W=PTA5*BR54"A
M"=2JY*L![K=3Z]&1]^ZUU[W[KW7O?NO=>]^Z]U[W[KW7O?NO=>]^Z]U[W[KW
M7O?NO=%D_P":5_\ ES?_ ,^5[]U;S_+_ "=?_]3>IRW_ #.?8/\ XC#MW_WJ
M^D??NO="?[]U[KWOW7NO>_=>Z][]U[J%D<=09?'U^)RM'39#&92BJL=D:"LA
M2HI*Z@K8'IJRCJH) T<]-4T\K(Z,"K*Q!X/OW7NJKME_R7_@SL[$]GX'^Z?8
MNXL1O_ [<V5MA=S=T]N9G+])]>[0JNN<]M79?2NXZ_>M1G>O:/;F\^K<+E*.
MJH)X:Z/^%T%(TKT=#!"ONMDD\>EK7_RG/AY7[!Q6RABNW,?G,7V1O[MR7NC%
M=]=N8WY!YSL'M;:T.Q>T<]N7NNEW:F_,\.PMC4D&'RM)45;T4^.IH(EA3P0E
M/=>U&I/1\>L^MMC].==['ZGZSV[1;2Z]ZWVK@MD[*VSCC4/1X+;.V\;3XG#8
MR&:KFJ:RI^UH:5%::>66>9@7D=W9F/NM<:GSZ*_MW_MXWW%_XI/\;?\ W^OR
ML]^ZWY#H['OW6NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[K
MWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=
M>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KW
MOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>
MZ][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWO
MW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z
M][]U[KWOW7NO>_=>Z][]U[HLG_-*_P#RYO\ ^?*]^ZMY_E_DZ__5WJ<M_P S
MGV#_ .(P[=_]ZOI'W[KW0G^_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>
MZ][]U[HD^W?^WC?<7_BD_P ;?_?Z_*SW[K?D.CL>_=:Z][]U[KWOW7NO>_=>
MZ][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWO
MW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z
M][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW
M7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z]
M[]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7
MNO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NBR?\TK_\
MN;_^?*]^ZMY_E_DZ_];>IRW_ #.?8/\ XC#MW_WJ^D??NO="?[]U[KWOW7NO
M>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NB3[=_[>-]Q?^*3_ !M_]_K\K/?N
MM^0Z.Q[]UKKWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U
M[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>
M_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[
MKWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_
M=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[K
MWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=
M>Z][]U[KWOW7NO>_=>Z+)_S2O_RYO_Y\KW[JWG^7^3K_U]ZG+?\ ,Y]@_P#B
M,.W?_>KZ1]^Z]T)_OW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z
M)/MW_MXWW%_XI/\ &W_W^ORL]^ZWY#H['OW6NO>_=>Z][]U[KWOW7NO>_=>Z
M][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW
M7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z]
M[]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7
MNO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][
M]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7N
MO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[HLG_-*__+F__GRO
M?NK>?Y?Y.O_0WJ<M_P SGV#_ .(P[=_]ZOI'W[KW0G^_=>Z][]U[KWOW7NO>
M_=>Z][]U[HI_SB[;[FZ*^+?:O:GQ_P"NI>T^U]JTFV7V]M*+:^X]\LE!EMZ;
M<P6[-UML79]?BMV;XBZ_V=D\AGGPN,J:>NRJXTTL,L;RAU]UL4)SPZIBZ9_F
M<_,'O'8GQ-ZLZF[0^&V_N]._:_Y%U]=W<G7W:E1M3;NU?C1TAU?V'FMG]I?'
M]][[#W/UOWMG]]=FTN(KZ9,[/BZ;$Q#+TE.R5D%%![JU *U'5T?P=^1\WR\^
M(?QW^2]9M^GVKDNY>K=L;SS6W**::IH,+N"MI/M]PX_&5%3_ )3/BJ;-TU0M
M*\O[K4V@OZB??NJL-)(/ET6K?_R)Z+^/O\Q/L2J[M[6V1U=3;H^%OQ]I]NS;
MSSE)A(\S/B>\OE#)DHL>U4Z"H>BCR$!D _2)5_K[]UZA(%!T,W_#D?P*_P"\
MM>C/_0\Q'_7[W[KU#Z=>_P"'(_@5_P!Y:]&?^AYB/^OWOW7J'TZ]_P .1_ K
M_O+7HS_T/,1_U^]^Z]0^G7O^'(_@5_WEKT9_Z'F(_P"OWOW7J'TZ]_PY'\"O
M^\M>C/\ T/,1_P!?O?NO4/IU[_AR/X%?]Y:]&?\ H>8C_K][]UZA].O?\.1_
M K_O+7HS_P!#S$?]?O?NO4/IU[_AR/X%?]Y:]&?^AYB/^OWOW7J'TZ]_PY'\
M"O\ O+7HS_T/,1_U^]^Z]0^G7O\ AR/X%?\ >6O1G_H>8C_K][]UZA].L%1_
M,L^ -'%YZOY>]"TL'DAB,U1V#A((O+4S1TU/'Y)9U3R3U$JH@O=G8*+D@>_=
M>TGTZS_\.1_ K_O+7HS_ -#S$?\ 7[W[KU#Z=>_X<C^!7_>6O1G_ *'F(_Z_
M>_=>H?3KW_#D?P*_[RUZ,_\ 0\Q'_7[W[KU#Z=>_X<C^!7_>6O1G_H>8C_K]
M[]UZA].O?\.1_ K_ +RUZ,_]#S$?]?O?NO4/IU[_ (<C^!7_ 'EKT9_Z'F(_
MZ_>_=>H?3KW_  Y'\"O^\M>C/_0\Q'_7[W[KU#Z=>_X<C^!7_>6O1G_H>8C_
M *_>_=>H?3KW_#D?P*_[RUZ,_P#0\Q'_ %^]^Z]0^G7O^'(_@5_WEKT9_P"A
MYB/^OWOW7J'TZ]_PY'\"O^\M>C/_ $/,1_U^O[]UZA].L$'\RSX U2R-2_+[
MH6I6&>>EE:G["PDRQ5-+*T-33R-'4,$GIYD*.A]2,"" 1[]UZA].L_\ PY'\
M"O\ O+7HS_T/,1_U^]^Z]0^G7O\ AR/X%?\ >6O1G_H>8C_K][]UZA].O?\
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M_P"OWOW7J'TZ]_PY'\"O^\M>C/\ T/,1_P!?O?NO4/IU[_AR/X%?]Y:]&?\
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M/BJ(W6YM[]U3I9^_=>Z][]U[KWOW7NO>_=>Z][]U[H@6>^<E=A/GCM?X53=
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M3'0K_%SX*)\<]W].[GR79S]AQ]#?!7I;X1];T+[/&VFQN-V#6ID>S>Q*F?\
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M][]U[KWOW7NO>_=>Z+)_S2O_ ,N;_P#GRO?NK>?Y?Y.O_]'>IRW_ #.?8/\
MXC#MW_WJ^D??NO="?[]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7
MNO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][
M]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7N
MO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]
MU[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO
M>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U
M[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>
M_=>Z][]U[KWOW7NO>_=>Z+)_S2O_ ,N;_P#GRO?NK>?Y?Y.O_]+>IRW_ #.?
M8/\ XC#MW_WJ^D??NO="?[]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[K
MWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=
M>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KW
MOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>
MZ][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWO
MW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z
M][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW7NO>_=>Z][]U[KWOW
M7NO>_=>Z][]U[KWOW7NO>_=>Z+)_S2O_ ,N;_P#GRO?NK>?Y?Y.O_]/>)[0_
MT:?WIV;_ 'P_TC_WJ_N_O;^['^CK_39]U_=_^([%_O?_ !/_ $0?L?;_ ,1_
M@OC_ (EZM5_MN/N??NO=)#_C%/\ X$]^?^\SO?NO=>_XQ5_X$]_[.=[]U[KW
M_&*O_ GO_9SO?NO=>_XQ5_X$]_[.=[]U[KW_ !BK_P ">_\ 9SO?NO=>_P",
M5?\ @3W_ +.=[]U[KW_&*O\ P)[_ -G.]^Z]U[_C%7_@3W_LYWOW7NO?\8J_
M\">_]G.]^Z]U[_C%7_@3W_LYWOW7NO?\8J_\">_]G.]^Z]U[_C%7_@3W_LYW
MOW7NO?\ &*O_  )[_P!G.]^Z]U[_ (Q5_P"!/?\ LYWOW7NO?\8J_P# GO\
MV<[W[KW7O^,5?^!/?^SG>_=>Z]_QBK_P)[_V<[W[KW7O^,5?^!/?^SG>_=>Z
M]_QBK_P)[_V<[W[KW7O^,5?^!/?^SG>_=>Z]_P 8J_\  GO_ &<[W[KW7O\
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M_LYWOW7NO?\ &*O_  )[_P!G.]^Z]U[_ (Q5_P"!/?\ LYWOW7NO?\8J_P#
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
end
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>18
<FILENAME>R1.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6832034048">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Document and Entity Information - USD ($)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1"></th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Feb. 07, 2019</div></th>
<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_md_DocumentAndEntityInformationAbstract', window );"><strong>Document And Entity Information [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_DocumentType', window );">Document Type</a></td>
<td class="text">10-K<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_AmendmentFlag', window );">Amendment Flag</a></td>
<td class="text">false<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_DocumentPeriodEndDate', window );">Document Period End Date</a></td>
<td class="text">Dec. 31,  2018<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_DocumentFiscalYearFocus', window );">Document Fiscal Year Focus</a></td>
<td class="text">2018<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_DocumentFiscalPeriodFocus', window );">Document Fiscal Period Focus</a></td>
<td class="text">FY<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_TradingSymbol', window );">Trading Symbol</a></td>
<td class="text">MD<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityRegistrantName', window );">Entity Registrant Name</a></td>
<td class="text">MEDNAX, INC.<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityCentralIndexKey', window );">Entity Central Index Key</a></td>
<td class="text">0000893949<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_CurrentFiscalYearEndDate', window );">Current Fiscal Year End Date</a></td>
<td class="text">--12-31<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityWellKnownSeasonedIssuer', window );">Entity Well-known Seasoned Issuer</a></td>
<td class="text">Yes<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityCurrentReportingStatus', window );">Entity Current Reporting Status</a></td>
<td class="text">Yes<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityVoluntaryFilers', window );">Entity Voluntary Filers</a></td>
<td class="text">No<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityFilerCategory', window );">Entity Filer Category</a></td>
<td class="text">Large Accelerated Filer<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityEmergingGrowthCompany', window );">Entity Emerging Company</a></td>
<td class="text">false<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityExTransitionPeriod', window );">Entity Ex Transition Period</a></td>
<td class="text">false<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityShellCompany', window );">Entity Shell Company</a></td>
<td class="text">false<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntitySmallBusiness', window );">Entity Small Business</a></td>
<td class="text">false<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityCommonStockSharesOutstanding', window );">Entity Common Stock, Shares Outstanding</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">87,920,463<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_dei_EntityPublicFloat', window );">Entity Public Float</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 3,943,237,534<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_AmendmentFlag">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>If the value is true, then the document is an amendment to previously-filed/accepted document.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_AmendmentFlag</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:booleanItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_CurrentFiscalYearEndDate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>End date of current fiscal year in the format --MM-DD.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_CurrentFiscalYearEndDate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:gMonthDayItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_DocumentFiscalPeriodFocus">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>This is focus fiscal period of the document report. For a first quarter 2006 quarterly report, which may also provide financial information from prior periods, the first fiscal quarter should be given as the fiscal period focus. Values: FY, Q1, Q2, Q3, Q4, H1, H2, M9, T1, T2, T3, M8, CY.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_DocumentFiscalPeriodFocus</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:fiscalPeriodItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_DocumentFiscalYearFocus">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>This is focus fiscal year of the document report in CCYY format. For a 2006 annual report, which may also provide financial information from prior periods, fiscal 2006 should be given as the fiscal year focus. Example: 2006.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_DocumentFiscalYearFocus</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:gYearItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_DocumentPeriodEndDate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The end date of the period reflected on the cover page if a periodic report. For all other reports and registration statements containing historical data, it is the date up through which that historical data is presented.  If there is no historical data in the report, use the filing date. The format of the date is CCYY-MM-DD.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_DocumentPeriodEndDate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:dateItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_DocumentType">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The type of document being provided (such as 10-K, 10-Q, 485BPOS, etc). The document type is limited to the same value as the supporting SEC submission type, or the word 'Other'.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_DocumentType</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:submissionTypeItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityCentralIndexKey">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>A unique 10-digit SEC-issued value to identify entities that have filed disclosures with the SEC. It is commonly abbreviated as CIK.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher SEC<br> -Name Regulation 12B<br> -Number 240<br> -Section 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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityCentralIndexKey</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:centralIndexKeyItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityCommonStockSharesOutstanding">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate number of shares or other units outstanding of each of registrant's classes of capital or common stock or other ownership interests, if and as stated on cover of related periodic report. Where multiple classes or units exist define each class/interest by adding class of stock items such as Common Class A [Member], Common Class B [Member] or Partnership Interest [Member] onto the Instrument [Domain] of the Entity Listings, Instrument.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityCommonStockSharesOutstanding</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityCurrentReportingStatus">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate 'Yes' or 'No' whether registrants (1) have filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that registrants were required to file such reports), and (2) have been subject to such filing requirements for the past 90 days. This information should be based on the registrant's current or most recent filing containing the related disclosure.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityCurrentReportingStatus</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:yesNoItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityEmergingGrowthCompany">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate if registrant meets the emerging growth company criteria.</p></div>
<a href="javascript:void(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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityEmergingGrowthCompany</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:booleanItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityExTransitionPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate if registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards.</p></div>
<a href="javascript:void(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 Securities Act<br> -Number 7A<br> -Section B<br> -Subsection 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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityExTransitionPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:booleanItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityFilerCategory">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate whether the registrant is one of the following: (1) Large Accelerated Filer, (2) Accelerated Filer, (3) Non-accelerated Filer, (4) Smaller Reporting Company (Non-accelerated), (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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityFilerCategory</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:filerCategoryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityPublicFloat">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>State aggregate market value of voting and non-voting common equity held by non-affiliates computed by reference to price at which the common equity was last sold, or average bid and asked price of such common equity, as of the last business day of registrant's most recently completed second fiscal quarter. The public float should be reported on the cover page of the registrants form 10K.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityPublicFloat</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityRegistrantName">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The exact name of the entity filing the report as specified in its charter, which is required by forms filed with the SEC.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher SEC<br> -Name Regulation 12B<br> -Number 240<br> -Section 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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityRegistrantName</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:normalizedStringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityShellCompany">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate if company meets the shell company criteria: a company with no or nominal operations, and with no or nominal assets or assets consisting solely of cash and cash equivalents.</p></div>
<a href="javascript:void(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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityShellCompany</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:booleanItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntitySmallBusiness">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicates that the company is a smaller reporting company with both a public float and revenues of less than $75 million.</p></div>
<a href="javascript:void(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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntitySmallBusiness</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:booleanItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityVoluntaryFilers">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate 'Yes' or 'No' if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityVoluntaryFilers</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:yesNoItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_EntityWellKnownSeasonedIssuer">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Indicate 'Yes' or 'No' if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Is used on Form Type: 10-K, 10-Q, 8-K, 20-F, 6-K, 10-K/A, 10-Q/A, 20-F/A, 6-K/A, N-CSR, N-Q, N-1A.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_EntityWellKnownSeasonedIssuer</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>dei:yesNoItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_dei_TradingSymbol">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Trading symbol of an instrument as listed on an exchange.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">dei_TradingSymbol</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>dei_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:normalizedStringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_DocumentAndEntityInformationAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Document And Entity Information.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_DocumentAndEntityInformationAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>19
<FILENAME>R2.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6832345120">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Consolidated Balance Sheets - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 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_AssetsCurrentAbstract', window );"><strong>Current assets:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashAndCashEquivalentsAtCarryingValue', window );">Cash and cash equivalents</a></td>
<td class="nump">$ 36,745<span></span>
</td>
<td class="nump">$ 60,200<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RestrictedCashCurrent', window );">Restricted cash</a></td>
<td class="nump">20,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesCurrent', window );">Short-term investments</a></td>
<td class="nump">21,923<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_AccountsReceivableNetCurrent', window );">Accounts receivable, net</a></td>
<td class="nump">542,272<span></span>
</td>
<td class="nump">503,999<span></span>
</td>
</tr>
<tr class="ro">
<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">18,763<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">17,706<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">657,409<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="text">&#160;<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">69,699<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">133,037<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">4,382,995<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">588,312<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">103,459<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">5,934,911<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">469,342<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">253<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">30,598<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">500,193<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">739,500<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">1,234,780<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">209,060<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">131,240<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">32,254<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">2,847,027<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; $.01 par value; 200,000 shares authorized; 87,820 and 93,721 shares issued and outstanding, respectively</a></td>
<td class="nump">878<span></span>
</td>
<td class="nump">937<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdditionalPaidInCapitalCommonStock', window );">Additional paid-in capital</a></td>
<td class="nump">992,647<span></span>
</td>
<td class="nump">1,017,328<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RetainedEarningsAccumulatedDeficit', window );">Retained earnings</a></td>
<td class="nump">2,094,359<span></span>
</td>
<td class="nump">2,048,189<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockholdersEquity', window );">Total shareholders' equity</a></td>
<td class="nump">3,087,884<span></span>
</td>
<td class="nump">3,066,454<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LiabilitiesAndStockholdersEquity', window );">Total liabilities and shareholders' equity</a></td>
<td class="nump">$ 5,934,911<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>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AssetsCurrentAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AssetsCurrentAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CashAndCashEquivalentsAtCarryingValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of currency on hand as well as demand deposits with banks or financial institutions. Includes other kinds of accounts that have the general characteristics of demand deposits. Also includes short-term, highly liquid investments that are both readily convertible to known amounts of cash and so near their maturity that they present insignificant risk of changes in value because of changes in interest rates. Excludes cash and cash equivalents within disposal group and discontinued operation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
<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_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>
</tr>
<tr>
<td style="padding-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_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>
</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_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>
</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_StockholdersEquityAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockholdersEquityAbstract</td>
</tr>
<tr>
<td style="padding-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>20
<FILENAME>R3.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6811733408">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Consolidated Balance Sheets (Parenthetical) - $ / shares<br></strong></div></th>
<th class="th"><div>Dec. 31, 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>
</td>
</tr>
<tr class="ro">
<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>
</td>
<td class="nump">$ 0.01<span></span>
</td>
</tr>
<tr class="re">
<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>
</td>
<td class="nump">1,000,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PreferredStockSharesIssued', window );">Preferred stock, issued</a></td>
<td class="nump">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockParOrStatedValuePerShare', window );">Common stock, par value</a></td>
<td class="nump">$ 0.01<span></span>
</td>
<td class="nump">$ 0.01<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockSharesAuthorized', window );">Common stock, shares authorized</a></td>
<td class="nump">200,000,000<span></span>
</td>
<td class="nump">200,000,000<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockSharesIssued', window );">Common stock, shares issued</a></td>
<td class="nump">87,820,000<span></span>
</td>
<td class="nump">93,721,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockSharesOutstanding', window );">Common stock, shares outstanding</a></td>
<td class="nump">87,820,000<span></span>
</td>
<td class="nump">93,721,000<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommonStockParOrStatedValuePerShare">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Face amount or stated value per share of common stock.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommonStockSharesAuthorized">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The maximum number of common shares permitted to be issued by an entity's charter and bylaws.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_CommonStockSharesIssued">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Total number of common shares of an entity that have been sold or granted to shareholders (includes common shares that were issued, repurchased and remain in the treasury). These shares represent capital invested by the firm's shareholders and owners, and may be all or only a portion of the number of shares authorized. Shares issued include shares outstanding and shares held in the treasury.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>21
<FILENAME>R4.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6833154896">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Consolidated Statements of Income - USD ($)<br> shares in Thousands, $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Sep. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Mar. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeStatementAbstract', window );"><strong>Income Statement [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax', window );">Net revenue</a></td>
<td class="nump">$ 932,696<span></span>
</td>
<td class="nump">$ 896,652<span></span>
</td>
<td class="nump">$ 915,918<span></span>
</td>
<td class="nump">$ 901,857<span></span>
</td>
<td class="nump">$ 910,820<span></span>
</td>
<td class="nump">$ 868,951<span></span>
</td>
<td class="nump">$ 842,944<span></span>
</td>
<td class="nump">$ 835,597<span></span>
</td>
<td class="nump">$ 3,647,123<span></span>
</td>
<td class="nump">$ 3,458,312<span></span>
</td>
<td class="nump">$ 3,183,159<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingExpensesAbstract', window );"><strong>Operating expenses:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_PracticeSalariesAndBenefits', window );">Practice salaries and benefits</a></td>
<td class="nump">657,061<span></span>
</td>
<td class="nump">625,717<span></span>
</td>
<td class="nump">620,980<span></span>
</td>
<td class="nump">631,830<span></span>
</td>
<td class="nump">617,455<span></span>
</td>
<td class="nump">586,476<span></span>
</td>
<td class="nump">561,418<span></span>
</td>
<td class="nump">572,385<span></span>
</td>
<td class="nump">2,535,588<span></span>
</td>
<td class="nump">2,337,734<span></span>
</td>
<td class="nump">2,031,220<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">29,381<span></span>
</td>
<td class="nump">30,159<span></span>
</td>
<td class="nump">31,833<span></span>
</td>
<td class="nump">30,655<span></span>
</td>
<td class="nump">32,353<span></span>
</td>
<td class="nump">29,497<span></span>
</td>
<td class="nump">30,872<span></span>
</td>
<td class="nump">27,796<span></span>
</td>
<td class="nump">122,028<span></span>
</td>
<td class="nump">120,518<span></span>
</td>
<td class="nump">118,416<span></span>
</td>
</tr>
<tr class="ro">
<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">112,789<span></span>
</td>
<td class="nump">102,905<span></span>
</td>
<td class="nump">107,908<span></span>
</td>
<td class="nump">108,776<span></span>
</td>
<td class="nump">108,895<span></span>
</td>
<td class="nump">101,430<span></span>
</td>
<td class="nump">103,015<span></span>
</td>
<td class="nump">103,765<span></span>
</td>
<td class="nump">432,378<span></span>
</td>
<td class="nump">417,105<span></span>
</td>
<td class="nump">372,572<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DepreciationDepletionAndAmortization', window );">Depreciation and amortization</a></td>
<td class="nump">29,891<span></span>
</td>
<td class="nump">28,709<span></span>
</td>
<td class="nump">26,518<span></span>
</td>
<td class="nump">26,163<span></span>
</td>
<td class="nump">26,414<span></span>
</td>
<td class="nump">25,116<span></span>
</td>
<td class="nump">25,735<span></span>
</td>
<td class="nump">25,614<span></span>
</td>
<td class="nump">111,281<span></span>
</td>
<td class="nump">102,879<span></span>
</td>
<td class="nump">89,264<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">829,122<span></span>
</td>
<td class="nump">787,490<span></span>
</td>
<td class="nump">787,239<span></span>
</td>
<td class="nump">797,424<span></span>
</td>
<td class="nump">785,117<span></span>
</td>
<td class="nump">742,519<span></span>
</td>
<td class="nump">721,040<span></span>
</td>
<td class="nump">729,560<span></span>
</td>
<td class="nump">3,201,275<span></span>
</td>
<td class="nump">2,978,236<span></span>
</td>
<td class="nump">2,611,472<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">103,574<span></span>
</td>
<td class="nump">109,162<span></span>
</td>
<td class="nump">128,679<span></span>
</td>
<td class="nump">104,433<span></span>
</td>
<td class="nump">125,703<span></span>
</td>
<td class="nump">126,432<span></span>
</td>
<td class="nump">121,904<span></span>
</td>
<td class="nump">106,037<span></span>
</td>
<td class="nump">445,848<span></span>
</td>
<td class="nump">480,076<span></span>
</td>
<td class="nump">571,687<span></span>
</td>
</tr>
<tr class="ro">
<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">967<span></span>
</td>
<td class="nump">1,302<span></span>
</td>
<td class="nump">1,202<span></span>
</td>
<td class="nump">1,464<span></span>
</td>
<td class="nump">2,777<span></span>
</td>
<td class="nump">235<span></span>
</td>
<td class="nump">365<span></span>
</td>
<td class="nump">576<span></span>
</td>
<td class="nump">4,935<span></span>
</td>
<td class="nump">3,953<span></span>
</td>
<td class="nump">2,019<span></span>
</td>
</tr>
<tr class="re">
<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">(25,448)<span></span>
</td>
<td class="num">(21,782)<span></span>
</td>
<td class="num">(21,604)<span></span>
</td>
<td class="num">(19,935)<span></span>
</td>
<td class="num">(19,844)<span></span>
</td>
<td class="num">(18,428)<span></span>
</td>
<td class="num">(18,535)<span></span>
</td>
<td class="num">(17,752)<span></span>
</td>
<td class="num">(88,769)<span></span>
</td>
<td class="num">(74,559)<span></span>
</td>
<td class="num">(63,092)<span></span>
</td>
</tr>
<tr class="ro">
<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">2,277<span></span>
</td>
<td class="nump">1,766<span></span>
</td>
<td class="nump">1,257<span></span>
</td>
<td class="nump">1,525<span></span>
</td>
<td class="num">(294)<span></span>
</td>
<td class="num">(240)<span></span>
</td>
<td class="nump">689<span></span>
</td>
<td class="nump">797<span></span>
</td>
<td class="nump">6,825<span></span>
</td>
<td class="nump">952<span></span>
</td>
<td class="nump">3,185<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">(22,204)<span></span>
</td>
<td class="num">(18,714)<span></span>
</td>
<td class="num">(19,145)<span></span>
</td>
<td class="num">(16,946)<span></span>
</td>
<td class="num">(17,361)<span></span>
</td>
<td class="num">(18,433)<span></span>
</td>
<td class="num">(17,481)<span></span>
</td>
<td class="num">(16,379)<span></span>
</td>
<td class="num">(77,009)<span></span>
</td>
<td class="num">(69,654)<span></span>
</td>
<td class="num">(57,888)<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">81,370<span></span>
</td>
<td class="nump">90,448<span></span>
</td>
<td class="nump">109,534<span></span>
</td>
<td class="nump">87,487<span></span>
</td>
<td class="nump">108,342<span></span>
</td>
<td class="nump">107,999<span></span>
</td>
<td class="nump">104,423<span></span>
</td>
<td class="nump">89,658<span></span>
</td>
<td class="nump">368,839<span></span>
</td>
<td class="nump">410,422<span></span>
</td>
<td class="nump">513,799<span></span>
</td>
</tr>
<tr class="re">
<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">(21,156)<span></span>
</td>
<td class="num">(24,873)<span></span>
</td>
<td class="num">(30,122)<span></span>
</td>
<td class="num">(24,059)<span></span>
</td>
<td class="nump">27,761<span></span>
</td>
<td class="num">(42,119)<span></span>
</td>
<td class="num">(40,725)<span></span>
</td>
<td class="num">(34,967)<span></span>
</td>
<td class="num">(100,210)<span></span>
</td>
<td class="num">(90,050)<span></span>
</td>
<td class="num">(189,203)<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">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">268,629<span></span>
</td>
<td class="nump">320,372<span></span>
</td>
<td class="nump">324,596<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest', window );">Net loss attributable to noncontrolling interests</a></td>
<td class="nump">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">318<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetIncomeLoss', window );">Net income attributable to MEDNAX, Inc.</a></td>
<td class="nump">$ 60,214<span></span>
</td>
<td class="nump">$ 65,575<span></span>
</td>
<td class="nump">$ 79,412<span></span>
</td>
<td class="nump">$ 63,428<span></span>
</td>
<td class="nump">$ 136,103<span></span>
</td>
<td class="nump">$ 65,880<span></span>
</td>
<td class="nump">$ 63,698<span></span>
</td>
<td class="nump">$ 54,691<span></span>
</td>
<td class="nump">$ 268,629<span></span>
</td>
<td class="nump">$ 320,372<span></span>
</td>
<td class="nump">$ 324,914<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareAbstract', window );"><strong>Net income attributable to MEDNAX, Inc.:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareBasic', window );">Earnings per share, Basic</a></td>
<td class="nump">$ 0.69<span></span>
</td>
<td class="nump">$ 0.72<span></span>
</td>
<td class="nump">$ 0.85<span></span>
</td>
<td class="nump">$ 0.68<span></span>
</td>
<td class="nump">$ 1.47<span></span>
</td>
<td class="nump">$ 0.71<span></span>
</td>
<td class="nump">$ 0.69<span></span>
</td>
<td class="nump">$ 0.59<span></span>
</td>
<td class="nump">$ 2.95<span></span>
</td>
<td class="nump">$ 3.47<span></span>
</td>
<td class="nump">$ 3.52<span></span>
</td>
</tr>
<tr class="re">
<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">$ 0.68<span></span>
</td>
<td class="nump">$ 0.72<span></span>
</td>
<td class="nump">$ 0.85<span></span>
</td>
<td class="nump">$ 0.68<span></span>
</td>
<td class="nump">$ 1.46<span></span>
</td>
<td class="nump">$ 0.71<span></span>
</td>
<td class="nump">$ 0.69<span></span>
</td>
<td class="nump">$ 0.59<span></span>
</td>
<td class="nump">$ 2.93<span></span>
</td>
<td class="nump">$ 3.45<span></span>
</td>
<td class="nump">$ 3.49<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareBasicOtherDisclosuresAbstract', window );"><strong>Weighted average common shares:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_WeightedAverageNumberOfSharesOutstandingBasic', window );">Basic</a></td>
<td class="nump">87,810<span></span>
</td>
<td class="nump">90,984<span></span>
</td>
<td class="nump">92,987<span></span>
</td>
<td class="nump">92,859<span></span>
</td>
<td class="nump">92,756<span></span>
</td>
<td class="nump">92,589<span></span>
</td>
<td class="nump">92,181<span></span>
</td>
<td class="nump">92,360<span></span>
</td>
<td class="nump">91,104<span></span>
</td>
<td class="nump">92,431<span></span>
</td>
<td class="nump">92,422<span></span>
</td>
</tr>
<tr class="ro">
<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">88,258<span></span>
</td>
<td class="nump">91,359<span></span>
</td>
<td class="nump">93,529<span></span>
</td>
<td class="nump">93,505<span></span>
</td>
<td class="nump">93,159<span></span>
</td>
<td class="nump">92,881<span></span>
</td>
<td class="nump">92,812<span></span>
</td>
<td class="nump">93,143<span></span>
</td>
<td class="nump">91,606<span></span>
</td>
<td class="nump">92,958<span></span>
</td>
<td class="nump">93,109<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>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EarningsPerShareAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EarningsPerShareAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EarningsPerShareBasic">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/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_IncomeStatementAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeStatementAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/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_NetIncomeLoss">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/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://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(22))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873765&amp;loc=SL114874048-224260<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://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(18))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873790&amp;loc=SL114874131-224263<br><br>Reference 5: 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(20))<br> -URI http://asc.fasb.org/extlink&amp;oid=115205541&amp;loc=SL114868664-224227<br><br>Reference 6: 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><br>Reference 7: 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_NetIncomeLoss</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of Net Income (Loss) attributable to noncontrolling interest.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/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 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=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 1A<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=114867106&amp;loc=SL7669619-108580<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetIncomeLossAttributableToNoncontrollingInterest</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NonoperatingIncomeExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate amount of income or expense from ancillary business-related activities (that is to say, excluding major activities considered part of the normal operations of the business).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>22
<FILENAME>R5.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6833230944">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Consolidated Statements of Equity - USD ($)<br> shares in Thousands</strong></div></th>
<th class="th"><div>Total</div></th>
<th class="th"><div>Common Stock [Member]</div></th>
<th class="th"><div>Additional Paid-in Capital [Member]</div></th>
<th class="th"><div>Retained Earnings [Member]</div></th>
<th class="th"><div>Noncontrolling Interests [Member]</div></th>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest', window );">Balance at Dec. 31, 2015</a></td>
<td class="nump">$ 2,437,846,000<span></span>
</td>
<td class="nump">$ 937,000<span></span>
</td>
<td class="nump">$ 926,235,000<span></span>
</td>
<td class="nump">$ 1,510,356,000<span></span>
</td>
<td class="nump">$ 318,000<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharesIssued', window );">Balance, Shares at Dec. 31, 2015</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">93,739<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProfitLoss', window );">Net income (loss)</a></td>
<td class="nump">324,596,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">324,914,000<span></span>
</td>
<td class="num">$ (318,000)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan</a></td>
<td class="nump">22,022,000<span></span>
</td>
<td class="nump">$ 5,000<span></span>
</td>
<td class="nump">22,017,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">473<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross', window );">Issuance of restricted stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 5,000<span></span>
</td>
<td class="num">(5,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross', window );">Issuance of restricted stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">505<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue', window );">Stock-based compensation expense</a></td>
<td class="nump">34,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">34,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures', window );">Forfeitures of restricted stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">$ (1,000)<span></span>
</td>
<td class="nump">1,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited', window );">Forfeitures of restricted stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">53<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodValue', window );">Repurchased common stock</a></td>
<td class="num">(61,828,000)<span></span>
</td>
<td class="num">$ (9,000)<span></span>
</td>
<td class="num">(12,075,000)<span></span>
</td>
<td class="num">(49,744,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodShares', window );">Repurchased common stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(946)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation', window );">Excess tax benefit related to employee stock incentive plans</a></td>
<td class="nump">4,131,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">4,131,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest', window );">Balance at Dec. 31, 2016</a></td>
<td class="nump">2,760,767,000<span></span>
</td>
<td class="nump">$ 937,000<span></span>
</td>
<td class="nump">974,304,000<span></span>
</td>
<td class="nump">1,785,526,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharesIssued', window );">Balance, Shares at Dec. 31, 2016</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">93,718<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProfitLoss', window );">Net income (loss)</a></td>
<td class="nump">320,372,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">320,372,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan</a></td>
<td class="nump">23,276,000<span></span>
</td>
<td class="nump">$ 5,000<span></span>
</td>
<td class="nump">23,271,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">528<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross', window );">Issuance of restricted stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 5,000<span></span>
</td>
<td class="num">(5,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross', window );">Issuance of restricted stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">536<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration', window );">Issuance of restricted stock for acquisition consideration</a></td>
<td class="nump">2,658,000<span></span>
</td>
<td class="nump">$ 1,000<span></span>
</td>
<td class="nump">2,657,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration', window );">Issuance of restricted stock for acquisition consideration, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">69<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue', window );">Stock-based compensation expense</a></td>
<td class="nump">29,573,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">29,573,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures', window );">Forfeitures of restricted stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">$ (1,000)<span></span>
</td>
<td class="nump">1,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited', window );">Forfeitures of restricted stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">92<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodValue', window );">Repurchased common stock</a></td>
<td class="num">(70,192,000)<span></span>
</td>
<td class="num">$ (10,000)<span></span>
</td>
<td class="num">(12,473,000)<span></span>
</td>
<td class="num">(57,709,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodShares', window );">Repurchased common stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(1,038)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest', window );">Balance at Dec. 31, 2017</a></td>
<td class="nump">3,066,454,000<span></span>
</td>
<td class="nump">$ 937,000<span></span>
</td>
<td class="nump">1,017,328,000<span></span>
</td>
<td class="nump">2,048,189,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharesIssued', window );">Balance, Shares at Dec. 31, 2017</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">93,721<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProfitLoss', window );">Net income (loss)</a></td>
<td class="nump">268,629,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">268,629,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan</a></td>
<td class="nump">18,919,000<span></span>
</td>
<td class="nump">$ 5,000<span></span>
</td>
<td class="nump">18,914,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation', window );">Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">495<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross', window );">Issuance of restricted stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 8,000<span></span>
</td>
<td class="num">(8,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross', window );">Issuance of restricted stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">770<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue', window );">Stock-based compensation expense</a></td>
<td class="nump">38,703,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">38,703,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_StockIssuedDuringPeriodValueStockSwaps', window );">Stock swaps</a></td>
<td class="num">(2,661,000)<span></span>
</td>
<td class="num">$ (1,000)<span></span>
</td>
<td class="num">(2,660,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_StockIssuedDuringPeriodSharesStockSwaps', window );">Stock swaps,shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(56)<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_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures', window );">Forfeitures of restricted stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">$ (1,000)<span></span>
</td>
<td class="nump">1,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited', window );">Forfeitures of restricted stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(69)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodValue', window );">Repurchased common stock</a></td>
<td class="num">(302,160,000)<span></span>
</td>
<td class="num">$ (70,000)<span></span>
</td>
<td class="num">(79,631,000)<span></span>
</td>
<td class="num">(222,459,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodShares', window );">Repurchased common stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(7,041)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation', window );">Excess tax benefit related to employee stock incentive plans</a></td>
<td class="nump">0<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest', window );">Balance at Dec. 31, 2018</a></td>
<td class="nump">$ 3,087,884,000<span></span>
</td>
<td class="nump">$ 878,000<span></span>
</td>
<td class="nump">$ 992,647,000<span></span>
</td>
<td class="nump">$ 2,094,359,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rc">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharesIssued', window );">Balance, Shares at Dec. 31, 2018</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">87,820<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Stock issued during period shares restricted stock acquisition consideration.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_StockIssuedDuringPeriodSharesRestrictedStockAcquisitionConsideration</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_StockIssuedDuringPeriodSharesStockSwaps">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Stock issued during period shares stock swaps.</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_StockIssuedDuringPeriodSharesStockSwaps</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Stock issued during period value restricted stock acquisition consideration.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_StockIssuedDuringPeriodValueStockSwaps">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Stock issued during period value stock swaps.</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_StockIssuedDuringPeriodValueStockSwaps</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase to additional paid-in capital (APIC) from recognition of equity-based compensation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 20<br> -Section 55<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=109196918&amp;loc=d3e11149-113907<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 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=109197908&amp;loc=d3e5047-113901<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 20<br> -Section 55<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=109196918&amp;loc=d3e11178-113907<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 10<br> -Section 35<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=79507207&amp;loc=d3e4534-113899<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in additional paid in capital (APIC) resulting from a tax benefit associated with share-based compensation plan other than an employee stock ownership plan (ESOP). Includes, but is not limited to, excess tax benefit.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 718<br> -SubTopic 740<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=109245112&amp;loc=d3e23524-113945<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProfitLoss">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/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_SharesIssued">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares of stock issued as of the balance sheet date, including shares that had been issued and were previously outstanding but which are now held in the treasury.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SharesIssued</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares related to Restricted Stock Award forfeited during the period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 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(28))<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 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=109259400&amp;loc=d3e21463-112644<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_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares (or other type of equity) issued during the period as a result of any equity-based compensation plan other than an employee stock ownership plan (ESOP), net of any shares forfeited. Shares issued could result from the issuance of restricted stock, the exercise of stock options, stock issued under employee stock purchase plans, and/or other employee benefit plans.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_StockIssuedDuringPeriodSharesShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Gross number of shares (or other type of equity) issued during the period as a result of any equity-based compensation plan other than an employee stock ownership plan (ESOP). Shares issued could result from the issuance of restricted stock, the exercise of stock options, stock issued under employee stock purchase plans, and/or other employee benefit plans.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssuedDuringPeriodSharesShareBasedCompensationGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Value of stock related to Restricted Stock Awards forfeited during the period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 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 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=109259400&amp;loc=d3e21463-112644<br><br>Reference 4: 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_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures</td>
</tr>
<tr>
<td style="padding-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_StockIssuedDuringPeriodValueShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Value of stock (or other type of equity) issued during the period as a result of any equity-based compensation plan other than an employee stock ownership plan (ESOP), net of stock value of such awards forfeited. Stock issued could result from the issuance of restricted stock, the exercise of stock options, stock issued under employee stock purchase plans, and/or other employee benefit plans.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 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 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=109197908&amp;loc=d3e5047-113901<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><br>Reference 5: 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 (d)(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_StockIssuedDuringPeriodValueShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Gross value of stock (or other type of equity) issued during the period as a result of any equity-based compensation plan other than an employee stock ownership plan (ESOP). Stock issued could result from the issuance of restricted stock, the exercise of stock options, stock issued under employee stock purchase plans, and/or other employee benefit plans.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssuedDuringPeriodValueShareBasedCompensationGross</td>
</tr>
<tr>
<td style="padding-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_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>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of stockholders' equity (deficit), net of receivables from officers, directors, owners, and affiliates of the entity, attributable to both the parent and noncontrolling interests. Amount excludes temporary equity. Alternate caption for the concept is permanent equity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 45<br> -Paragraph 16<br> -URI http://asc.fasb.org/extlink&amp;oid=108774443&amp;loc=SL4568740-111683<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 55<br> -Paragraph 4I<br> -URI http://asc.fasb.org/extlink&amp;oid=84234705&amp;loc=SL4590271-111686<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 45<br> -Paragraph 15<br> -URI http://asc.fasb.org/extlink&amp;oid=108774443&amp;loc=SL4568447-111683<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>23
<FILENAME>R6.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6831747456">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Consolidated Statements of Cash Flows - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_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>
<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">$ 268,629<span></span>
</td>
<td class="nump">$ 320,372<span></span>
</td>
<td class="nump">$ 324,596<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract', window );"><strong>Adjustments to reconcile net income to net cash provided from operating activities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DepreciationDepletionAndAmortization', window );">Depreciation and amortization</a></td>
<td class="nump">111,281<span></span>
</td>
<td class="nump">102,879<span></span>
</td>
<td class="nump">89,264<span></span>
</td>
</tr>
<tr class="re">
<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">4,572<span></span>
</td>
<td class="nump">5,514<span></span>
</td>
<td class="nump">4,816<span></span>
</td>
</tr>
<tr class="ro">
<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">38,703<span></span>
</td>
<td class="nump">29,573<span></span>
</td>
<td class="nump">34,000<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_DeferredIncomeTaxExpenseBenefit', window );">Deferred income taxes</a></td>
<td class="num">(24,149)<span></span>
</td>
<td class="num">(60,073)<span></span>
</td>
<td class="nump">18,149<span></span>
</td>
</tr>
<tr class="ro">
<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">(10,903)<span></span>
</td>
<td class="num">(3,783)<span></span>
</td>
<td class="nump">212<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInOperatingCapitalAbstract', window );"><strong>Changes in assets and liabilities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInAccountsReceivable', window );">Accounts receivable</a></td>
<td class="num">(36,598)<span></span>
</td>
<td class="nump">7,803<span></span>
</td>
<td class="num">(34,000)<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_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets', window );">Prepaid expenses and other current assets</a></td>
<td class="num">(5,472)<span></span>
</td>
<td class="num">(2,792)<span></span>
</td>
<td class="num">(783)<span></span>
</td>
</tr>
<tr class="ro">
<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">(395)<span></span>
</td>
<td class="num">(2,709)<span></span>
</td>
<td class="nump">10,035<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities', window );">Accounts payable and accrued expenses</a></td>
<td class="nump">15,390<span></span>
</td>
<td class="nump">24,551<span></span>
</td>
<td class="nump">11,617<span></span>
</td>
</tr>
<tr class="ro">
<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">(61,256)<span></span>
</td>
<td class="nump">73,050<span></span>
</td>
<td class="num">(2,234)<span></span>
</td>
</tr>
<tr class="re">
<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">(1,093)<span></span>
</td>
<td class="num">(750)<span></span>
</td>
<td class="num">(1,037)<span></span>
</td>
</tr>
<tr class="ro">
<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">(4,490)<span></span>
</td>
<td class="nump">18,478<span></span>
</td>
<td class="num">(3,452)<span></span>
</td>
</tr>
<tr class="re">
<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">(4,294)<span></span>
</td>
<td class="num">(735)<span></span>
</td>
<td class="num">(7,405)<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">289,925<span></span>
</td>
<td class="nump">511,378<span></span>
</td>
<td class="nump">443,778<span></span>
</td>
</tr>
<tr class="re">
<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>
<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">(114,491)<span></span>
</td>
<td class="num">(531,696)<span></span>
</td>
<td class="num">(762,302)<span></span>
</td>
</tr>
<tr class="re">
<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">(27,723)<span></span>
</td>
<td class="num">(60,976)<span></span>
</td>
</tr>
<tr class="ro">
<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">13,710<span></span>
</td>
<td class="nump">25,410<span></span>
</td>
<td class="nump">41,325<span></span>
</td>
</tr>
<tr class="re">
<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">(48,868)<span></span>
</td>
<td class="num">(49,309)<span></span>
</td>
<td class="num">(39,264)<span></span>
</td>
</tr>
<tr class="ro">
<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>
<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">6,705<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetCashProvidedByUsedInInvestingActivities', window );">Net cash used in investing activities</a></td>
<td class="num">(142,769)<span></span>
</td>
<td class="num">(576,613)<span></span>
</td>
<td class="num">(821,217)<span></span>
</td>
</tr>
<tr class="re">
<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>
<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">1,723,500<span></span>
</td>
<td class="nump">2,846,000<span></span>
</td>
<td class="nump">1,940,000<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">(2,094,500)<span></span>
</td>
<td class="num">(2,699,000)<span></span>
</td>
<td class="num">(1,510,000)<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_ProceedsFromIssuanceOfSeniorLongTermDebt', window );">Proceeds from issuance of senior notes</a></td>
<td class="nump">500,000<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_PaymentsOfFinancingCosts', window );">Payments for financing costs</a></td>
<td class="num">(7,090)<span></span>
</td>
<td class="num">(3,525)<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_PaymentForContingentConsiderationLiabilityFinancingActivities', window );">Payments of contingent consideration liabilities</a></td>
<td class="num">(5,263)<span></span>
</td>
<td class="num">(5,449)<span></span>
</td>
<td class="num">(10,740)<span></span>
</td>
</tr>
<tr class="re">
<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">(1,356)<span></span>
</td>
<td class="num">(2,267)<span></span>
</td>
<td class="num">(2,130)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities', window );">Excess tax benefit from exercises of stock options and vesting of restricted stock</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">4,241<span></span>
</td>
</tr>
<tr class="re">
<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">16,258<span></span>
</td>
<td class="nump">23,276<span></span>
</td>
<td class="nump">22,022<span></span>
</td>
</tr>
<tr class="ro">
<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>
<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_PaymentsForRepurchaseOfCommonStock', window );">Repurchases of common stock</a></td>
<td class="num">(302,160)<span></span>
</td>
<td class="num">(70,192)<span></span>
</td>
<td class="num">(61,828)<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_NetCashProvidedByUsedInFinancingActivities', window );">Net cash (used in) provided from financing activities</a></td>
<td class="num">(170,611)<span></span>
</td>
<td class="nump">89,737<span></span>
</td>
<td class="nump">381,565<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_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect', window );">Net (decrease) increase in cash and cash equivalents</a></td>
<td class="num">(23,455)<span></span>
</td>
<td class="nump">24,502<span></span>
</td>
<td class="nump">4,126<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents', window );">Cash, cash equivalents and restricted cash at beginning of year</a></td>
<td class="nump">80,200<span></span>
</td>
<td class="nump">55,698<span></span>
</td>
<td class="nump">51,572<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents', window );">Cash, cash equivalents and restricted cash at end of year</a></td>
<td class="nump">56,745<span></span>
</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_SupplementalCashFlowInformationAbstract', window );"><strong>Supplemental disclosure of cash flow information:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InterestPaidNet', window );">Interest</a></td>
<td class="nump">82,540<span></span>
</td>
<td class="nump">73,837<span></span>
</td>
<td class="nump">60,453<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxesPaidNet', window );">Income taxes</a></td>
<td class="nump">185,416<span></span>
</td>
<td class="nump">75,427<span></span>
</td>
<td class="nump">175,962<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract', window );"><strong>Non-cash investing and financing activities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssued1', window );">Value of common stock issued for acquisitions</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">2,657<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_CapitalLeaseObligationsIncurred', window );">Equipment financed through capital leases</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">684<span></span>
</td>
<td class="nump">1,619<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalExpendituresIncurredButNotYetPaid', window );">Property and equipment included in accounts payable</a></td>
<td class="nump">$ 2,927<span></span>
</td>
<td class="nump">$ 2,700<span></span>
</td>
<td class="nump">$ 2,673<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_CapitalExpendituresIncurredButNotYetPaid">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Future cash outflow to pay for purchases of fixed assets that have occurred.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 5<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4332-108586<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 50<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4313-108586<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 3<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4304-108586<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalExpendituresIncurredButNotYetPaid</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeaseObligationsIncurred">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The increase during the period in capital lease obligations due to entering into new capital leases.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 4<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4313-108586<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 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4304-108586<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeaseObligationsIncurred</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_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_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CashFlowNoncashInvestingAndFinancingActivitiesDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredIncomeTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred income tax expense (benefit) pertaining to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash inflow from realized tax benefit related to deductible compensation cost reported on the entity's tax return for equity instruments in excess of the compensation cost for those instruments recognized for financial reporting purposes.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 718<br> -SubTopic 20<br> -Section 55<br> -Paragraph 24<br> -URI http://asc.fasb.org/extlink&amp;oid=109196918&amp;loc=d3e11374-113907<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ExcessTaxBenefitFromShareBasedCompensationFinancingActivities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxesPaidNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of cash paid during the current period to foreign, federal, state, and local authorities as taxes on income, net of any cash received during the current period as refunds for the overpayment of taxes.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 2<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4297-108586<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxesPaidNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The increase (decrease) during the reporting period in the amounts payable to vendors for goods and services received and the amount of obligations and expenses incurred but not paid.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_InterestPaidNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash paid for interest, excluding capitalized interest, classified as operating activity. Includes, but is not limited to, payment to settle zero-coupon bond for accreted interest of debt discount and debt instrument with insignificant coupon interest rate in relation to effective interest rate of borrowing attributable to accreted interest of debt discount.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4297-108586<br><br>Reference 2: 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 17<br> -Subparagraph (d)<br> -URI http://asc.fasb.org/extlink&amp;oid=109223946&amp;loc=d3e3367-108585<br><br>Reference 3: 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 25<br> -Subparagraph (e)<br> -URI http://asc.fasb.org/extlink&amp;oid=109223946&amp;loc=d3e3536-108585<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InterestPaidNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_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_PaymentsOfFinancingCosts">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash outflow for loan and debt issuance costs.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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> -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_PaymentsOfFinancingCosts</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash outflow associated with the acquisition of a business, net of the cash acquired from the purchase.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_ProceedsFromIssuanceOfSeniorLongTermDebt">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash inflow from a borrowing with the highest claim on the assets of the entity in case of bankruptcy or liquidation (with maturities initially due after one year or beyond the operating cycle, if longer).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProceedsFromIssuanceOfSeniorLongTermDebt</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProceedsFromLinesOfCredit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash inflow from contractual arrangement with the lender, including but not limited to, letter of credit, standby letter of credit and revolving credit arrangements.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_RepaymentsOfLongTermCapitalLeaseObligations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash outflow for the obligation for a lease meeting the criteria for capitalization (with maturities exceeding one year or beyond the operating cycle of the entity, if longer).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RepaymentsOfLongTermCapitalLeaseObligations</td>
</tr>
<tr>
<td style="padding-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_ShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 noncash, equity-based employee remuneration. This may include the value of stock or unit options, amortization of restricted stock or units, and adjustment for officers' compensation. As noncash, this element is an add back when calculating net cash generated by operating activities using the indirect method.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_ShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-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_StockIssued1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 fair value of stock issued in noncash financing activities.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 3<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4304-108586<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 50<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4332-108586<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 4<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4313-108586<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssued1</td>
</tr>
<tr>
<td style="padding-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_SupplementalCashFlowInformationAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_SupplementalCashFlowInformationAbstract</td>
</tr>
<tr>
<td style="padding-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>24
<FILENAME>R7.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823081888">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>General<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract', window );"><strong>Organization, Consolidation and Presentation of Financial Statements [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NatureOfOperations', window );">General</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>1.&#xA0;&#xA0;&#xA0;&#xA0;General:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The principal business activity of MEDNAX, Inc.
 (&#x201C;MEDNAX&#x201D; or the &#x201C;Company&#x201D;) and its
 subsidiaries is to provide neonatal, anesthesia, radiology and
 teleradiology, maternal-fetal and other pediatric subspecialty
 physician services. The Company has contracts with affiliated
 business corporations or professional associations, limited
 liability companies and partnerships (&#x201C;affiliated
 professional contractors&#x201D;), which are separate legal entities
 that provide physician services in certain states and Puerto Rico.
 The Company and its affiliated professional contractors also have
 contracts with hospitals and other healthcare facilities to provide
 physician services, which include&#xA0;<font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">(i)&#xA0;fee-for-service</font></font>&#xA0;contracts,
 whereby hospitals and other customers agree, in exchange for the
 Company&#x2019;s services, to authorize the Company and its
 healthcare professionals to bill and collect the charges for
 medical services rendered by the Company&#x2019;s affiliated
 healthcare professionals, and (ii)&#xA0;administrative fee
 contracts, whereby the Company is assured a minimum revenue
 level.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 In addition to its national physician network, the Company also
 provides services nationwide to healthcare providers, including its
 own, through complementary businesses including a management
 services organization specializing in full-service revenue cycle
 management and a consulting services company.</p>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NatureOfOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for the nature of an entity's business, major products or services, principal markets including location, and the relative importance of its operations in each business and the basis for the determination, including but not limited to, assets, revenues, or earnings. For an entity that has not commenced principal operations, disclosures about the risks and uncertainties related to the activities in which the entity is currently engaged and an understanding of what those activities are being directed toward.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e5967-108592<br><br>Reference 2: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -URI http://asc.fasb.org/topic&amp;trid=2134479<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NatureOfOperations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract</td>
</tr>
<tr>
<td style="padding-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>25
<FILENAME>R8.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6708797696">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Summary of Significant Accounting Policies<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_SignificantAccountingPoliciesTextBlock', window );">Summary of Significant Accounting Policies</a></td>
<td class="text"><div>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" border="0">
 <tr style="break-inside: avoid">
 <td valign="top" width="4%" align="left">
 <b>2.&#xA0;&#xA0;&#xA0;&#xA0;Summary</b></td>
 <td valign="top" align="left">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-TOP: 0pt" align="left"><b>of Significant Accounting Policies:</b></p>
 </td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Principles of Presentation</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The consolidated financial statements include all the accounts of
 the Company and its subsidiaries combined with the accounts of the
 affiliated professional contractors with which the Company
 currently has specific management arrangements. The Company&#x2019;s
 agreements with affiliated professional contractors provide that
 the term of the arrangements are in most cases permanent, subject
 only to termination by the Company, except in the case of gross
 negligence, fraud or bankruptcy of the Company. The Company has the
 right to receive income, both as ongoing fees and as proceeds from
 the sale of its interest in the Company&#x2019;s affiliated
 professional contractors, in an amount that fluctuates based on the
 performance of the affiliated professional contractors and the
 change in the fair value of the Company&#x2019;s interest in the
 affiliated professional contractors. The Company has exclusive
 responsibility for the provision of
 all&#xA0;<font style="WHITE-SPACE: nowrap">non-medical</font>&#xA0;services
 required for the&#xA0;<font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">day-to-day</font></font>&#xA0;operation
 and management of the Company&#x2019;s affiliated professional
 contractors and establishes the guidelines for the employment and
 compensation of the physicians. In addition, the agreements provide
 that the Company has the right, but not the obligation, to
 purchase, or to designate a person(s) to purchase, the stock of the
 Company&#x2019;s affiliated professional contractors for a nominal
 amount. Separately, in its sole discretion, the Company has the
 right to assign its interest in the agreements. Based upon the
 provisions of these agreements, the Company has determined that the
 affiliated professional contractors are variable interest entities
 and that the Company is the primary beneficiary as defined in the
 accounting guidance for consolidation. All significant intercompany
 and interaffiliate accounts and transactions have been
 eliminated.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 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.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Recently Adopted Accounting Pronouncements</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 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 the Company&#x2019;s 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.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>New Accounting Pronouncements</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 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 became 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 has
 accumulated all of the necessary information required to properly
 account for leases under the new guidance. The Company has
 implemented a cloud-based software application, inclusive of a
 lease administration module and an accounting module. The Company
 is in the process of finalizing workflows, business processes and
 internal controls surrounding the new lease accounting process in
 order to meet the reporting and disclosure requirements.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Accounting Estimates and Assumptions</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The preparation of financial statements in conformity with
 accounting principles generally accepted in the United States
 (&#x201C;GAAP&#x201D;) requires management to make estimates and
 assumptions that affect the reported amounts of assets and
 liabilities and disclosure of contingent assets and liabilities at
 the date of the financial statements and the reported amounts of
 revenue and expenses during the reporting periods. Significant
 estimates and assumptions are involved in the calculation of the
 Company&#x2019;s allowance for contractual adjustments and
 uncollectibles on accounts receivable, liabilities for self-insured
 amounts and claims incurred but not reported related to the
 Company&#x2019;s professional liability risks and the fair value of
 goodwill. Actual results could differ from those estimates.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Segment Reporting</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The results of the Company&#x2019;s operations are aggregated into a
 single reportable segment for purposes of presenting financial
 information in accordance with the accounting guidance for segment
 reporting.</p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The following table summarizes the Company&#x2019;s net revenue by
 service line (in percentages):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center">
 <b>Years&#xA0;Ended&#xA0;December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Neonatology and other pediatric subspecialties</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">36</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">37</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">39</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Anesthesiology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">38</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">39</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Radiology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">12</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Maternal-fetal medicine</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Management services</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">5</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Pediatric cardiology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Revenue Recognition</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 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 GHC
 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: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 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 GHC Programs and third-party
 insurance payors for such services.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 Collection of patient service revenue the Company expects to
 receive is normally a function of providing complete and correct
 billing information to the GHC 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: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 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: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 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: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 Accounts receivable are primarily amounts due
 under&#xA0;<font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">fee-for-service</font></font>&#xA0;contracts
 from third-party payors, such as insurance companies, self-insured
 employers and patients and GHC Programs geographically dispersed
 throughout the United States and its territories. Concentration of
 credit risk relating to accounts receivable is limited by the
 number, diversity and geographic dispersion of the business units
 managed by the Company, as well as by the large number of patients
 and payors, including the various governmental agencies in the
 states in which the Company provides services. Receivables from
 government agencies made up approximately 19% and 17% of net
 accounts receivable at December&#xA0;31, 2018 and 2017,
 respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Cash and Cash Equivalents</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 Cash equivalents are defined as all highly liquid financial
 instruments with maturities of 90 days or less from the date of
 purchase. The Company&#x2019;s cash equivalents typically consist of
 demand deposits, amounts on deposit in money market accounts, and
 funds invested in overnight repurchase agreements. Cash equivalent
 balances may, at certain times, exceed federally insured
 limits.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 Certain cash equivalents carried by the Company are subject to the
 fair value provisions of the accounting guidance for fair value
 measurements. See &#x201C;Fair Value Measurements&#x201D; below.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Restricted Cash</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 Restricted cash consists of funds in escrow related to a potential
 future payment for contingent consideration for an acquisition
 completed in 2017.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Investments</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 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 five years.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company intends and has the ability to hold its securities to
 maturity, and therefore carries such investments at amortized cost
 in accordance with the provisions of the accounting guidance for
 investments in debt securities.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Property and Equipment</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 Property and equipment are recorded at original purchase cost.
 Depreciation of property and equipment is computed using the
 straight-line method over the estimated useful lives of the
 underlying assets. Estimated useful lives are generally 30 years
 for buildings; three to seven years for medical equipment, computer
 equipment, software and furniture; and the lesser of the useful
 life or the remaining lease term for leasehold improvements and
 capital leases. Upon sale or retirement of property and equipment,
 the related cost and accumulated depreciation are eliminated from
 the respective accounts and any resulting gain or loss is included
 in earnings.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Business Acquisitions</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company accounts for all business acquisitions at fair value
 and expenses acquisition costs as they are incurred. Any
 identifiable assets acquired and liabilities assumed are recognized
 and measured at their respective fair values on the acquisition
 date. If information about facts and circumstances existing as of
 the acquisition date is incomplete at the end of the reporting
 period in which a business acquisition occurs, the Company will
 report provisional amounts for the items for which the accounting
 is incomplete. The measurement period ends once the Company
 receives sufficient information to finalize the fair values;
 however, the period will not exceed one year from the acquisition
 date. Any adjustments to provisional amounts that are identified
 during the measurement period are recognized in the reporting
 period in which the adjustment amounts are determined.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 In connection with certain acquisitions, the Company enters into
 agreements to pay additional amounts in cash or common stock based
 on the achievement of certain performance measures for up to five
 years ending after the acquisition dates. The Company measures this
 contingent consideration at fair value at the acquisition date and
 records such contingent consideration as a liability or equity on
 the Company&#x2019;s Consolidated Balance Sheets on the acquisition
 date. The fair value of each contingent consideration liability is
 remeasured at each reporting period with any change in fair value
 recognized as income or expense within operations in the
 Company&#x2019;s Consolidated Statements of Income. See Note 6 for
 more information on the Company&#x2019;s business acquisitions.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Goodwill and Other Intangible Assets</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company records acquired assets and assumed liabilities at
 their respective fair values under the acquisition method of
 accounting. Goodwill represents the excess of purchase price over
 the fair value of the net assets acquired. Intangible assets with
 finite lives, principally physician and hospital agreements,
 customer relationships, patented technology and trade names, are
 recognized apart from goodwill at the time of acquisition based on
 the contractual-legal and separability criteria established in the
 accounting guidance. Intangible assets with finite lives are
 amortized on either an accelerated basis based on the annual
 undiscounted economic cash flows associated with the particular
 intangible asset or on a straight-line basis over their estimated
 useful lives. Intangible assets with finite lives are amortized
 over periods of one to 20 years.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 Goodwill is tested for impairment at a reporting unit level on at
 least an annual basis in accordance with the subsequent measurement
 provisions of the accounting guidance for goodwill. The Company
 defines a reporting unit based upon its management structure for
 services provided in specific regions of the United States. The
 Company early adopted new accounting guidance in 2017 that requires
 only a single-step quantitative test with any goodwill impairment
 measured as the amount by which a reporting unit&#x2019;s carrying
 value exceeds its fair value. The Company uses income and
 market-based valuation approaches to determine the fair value of
 its reporting units. These approaches focus on discounted cash
 flows and market multiples based on the Company&#x2019;s market
 capitalization to derive the fair value of a reporting unit. The
 Company also considers the economic outlook for the healthcare
 services industry and various other factors during the testing
 process, including hospital and physician contract changes, local
 market developments, changes in third-party payor payments, and
 other publicly available information. The Company completed annual
 impairment tests in the third quarter of each of 2018, 2017 and
 2016 and determined that goodwill was not impaired in any of the
 three years.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Long-Lived Assets</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company is required to evaluate long-lived assets, including
 intangible assets subject to amortization, whenever events or
 changes in circumstances indicate that the carrying value of the
 assets may not be fully recoverable. The recoverability of such
 assets is measured by a comparison of the carrying value of the
 assets to the future undiscounted cash flows before interest
 charges to be generated by the assets. If long-lived assets are
 impaired, the impairment to be recognized is measured as the excess
 of the carrying value over the fair value. Long-lived assets held
 for disposal are reported at the lower of the carrying value or
 fair value less disposal costs. The Company does not believe there
 are any indicators that would require an adjustment to such assets
 or their estimated periods of recovery at December&#xA0;31, 2018
 pursuant to current accounting standards.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Common Stock Repurchases</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company repurchases shares of its common stock as authorized
 from time to time by its Board of Directors. The Company treats
 repurchased shares of its common stock as retired as any
 repurchased shares become authorized but unissued shares. The
 reacquisition cost of repurchased shares is recorded as a reduction
 in the respective components of shareholders&#x2019; equity.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Professional Liability Coverage</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company maintains professional liability insurance policies
 with third-party insurers generally on a claims-made basis, subject
 to deductibles or self-insured retention, exclusions and other
 restrictions. The Company&#x2019;s self-insured retention under its
 professional liability insurance program is maintained primarily
 through a wholly owned captive insurance subsidiary. The Company
 records an estimate of liabilities for self-insured amounts and
 claims incurred but not reported based on an actuarial valuation
 using historical loss information, claim emergence patterns and
 various actuarial assumptions. Liabilities for claims incurred but
 not reported are not discounted.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Income Taxes</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company records deferred income taxes using the liability
 method, whereby deferred tax assets and liabilities are determined
 based on the difference between the financial statement and tax
 bases of assets and liabilities using enacted tax rates in effect
 for the year in which the differences are expected to reverse. If
 it is more likely than not that all or a portion of deferred tax
 assets will not be realized, a valuation allowance is provided
 against such deferred tax assets. In making such determination, the
 Company considers all available positive and negative evidence,
 including future reversals of existing taxable temporary
 differences, projected future taxable
 income,&#xA0;<font style="WHITE-SPACE: nowrap">tax-planning</font>&#xA0;strategies,
 and results of recent operations.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The accounting guidance for uncertain tax positions prescribes a
 recognition threshold and measurement attribute for financial
 statement recognition and measurement of a tax position taken or
 expected to be taken in a tax return. The guidance also requires
 policy disclosures regarding penalties and interest and extensive
 disclosures regarding increases and decreases in uncertain tax
 positions as a result of tax positions taken in a current or prior
 period, settlements with taxing authorities and any lapse of an
 applicable statute of limitations. Additional qualitative
 discussion is required for any tax position that may result in a
 significant increase or decrease in uncertain tax positions within
 a&#xA0;<font style="WHITE-SPACE: nowrap">12-month</font>&#xA0;period from
 the Company&#x2019;s reporting date.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Stock Incentive Plans</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company grants stock-based awards consisting primarily of
 restricted stock to key employees under its Amended and Restated
 2008 Incentive Compensation Plan, as amended. The Company measures
 the cost of employee services received in exchange for stock-based
 awards based on grant-date fair value and allocates the resulting
 compensation expense over the corresponding requisite service
 period using the graded vesting attribution method. The Company
 also performs analyses to estimate forfeitures of stock-based
 awards on an annual basis and adjusts the estimates as necessary
 based on the number of awards that ultimately vest.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Net Income Per Common Share</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 Basic net income per common share is calculated by dividing net
 income by the weighted average number of common shares outstanding
 during the period. Diluted net income per common share is
 calculated by dividing net income by the weighted average number of
 common and potential common shares outstanding during the period.
 Potential common shares consist of outstanding restricted stock,
 deferred stock and stock options and is calculated using the
 treasury stock method. On January&#xA0;1, 2017, the Company adopted
 new accounting guidance that no longer permits the Company to
 include the assumed excess tax benefits related to the potential
 exercise or vesting of its stock-based awards in the treasury stock
 method computation.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Fair Value Measurements</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 In accordance with the accounting guidance for fair value
 measurements and disclosures, the Company carries its money market
 funds included in cash and cash equivalents at fair value. In
 accordance with the three-tier fair value hierarchy under this
 guidance, the Company determined the fair value using quoted market
 prices, a Level&#xA0;1 input as defined under the accounting
 guidance for fair value measurements. At December&#xA0;31, 2018 and
 2017, the Company&#x2019;s money market funds had a fair value of
 $0.5&#xA0;million and $9.2&#xA0;million, respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company also carries the cash surrender value of life insurance
 related to its deferred compensation arrangements at fair value.
 The investments underlying the life insurance contracts consist
 primarily of exchange-traded equity securities and mutual funds
 with quoted prices in active markets. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value using the cash surrender value of the life insurance, a
 Level&#xA0;2 input as defined under the accounting guidance for
 fair value measurements. At December&#xA0;31, 2018 and 2017, the
 Company&#x2019;s cash surrender value of life insurance had a fair
 value of $10.5&#xA0;million and $15.6&#xA0;million,
 respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 In addition, the Company carries its contingent consideration
 liabilities related to acquisitions at fair value. In accordance
 with the three-tier fair value hierarchy, the Company determined
 the fair value of its contingent consideration liabilities using
 the income approach with assumed discount rates and payment
 probabilities. The income approach uses Level&#xA0;3, or
 unobservable inputs as defined under the accounting guidance for
 fair value measurements. At December&#xA0;31, 2018 and 2017, the
 Company&#x2019;s contingent consideration liabilities had a fair
 value of $20.0&#xA0;million and $30.5&#xA0;million, respectively.
 See Note 6 for more information regarding the Company&#x2019;s
 contingent consideration liabilities.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The carrying amounts of cash equivalents, short-term investments,
 accounts receivable and accounts payable and accrued expenses
 approximate fair value due to the short maturities of the
 respective instruments. The carrying values of long-term
 investments, line of credit, variable rate long-term debt and
 capital lease obligations approximate fair value. If the
 Company&#x2019;s investments were measured at fair value, they would
 be categorized as Level&#xA0;2 in the fair value hierarchy. If the
 Company&#x2019;s line of credit was measured at fair value, it would
 be categorized as Level&#xA0;2 in the fair value hierarchy. See
 Note 10 for information regarding the fair value of the
 Company&#x2019;s 5.25% senior unsecured notes due 2023 (the
 &#x201C;2023 Notes&#x201D;) and 6.25% senior unsecured notes due 2027
 (the &#x201C;2027 Notes&#x201D;).</p>
 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccountingPoliciesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_AccountingPoliciesAbstract</td>
</tr>
<tr>
<td style="padding-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_SignificantAccountingPoliciesTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for all significant accounting policies of the reporting 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 235<br> -URI http://asc.fasb.org/topic&amp;trid=2122369<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SignificantAccountingPoliciesTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>26
<FILENAME>R9.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823090448">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Investments<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock', window );">Investments</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>3. &#xA0;&#xA0;&#xA0;&#xA0;Investments:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Investments held are summarized as follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="52%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31, 2018</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">18,473</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">30,841</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</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: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Federal home loan securities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,000</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">34,393</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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">1,450</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,465</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">21,923</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">69,699</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Contractual maturities of long-term investments are summarized as
 follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="74%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">69,699</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,561</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Due after five years through six years</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,121</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">69,699</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_InvestmentsDebtAndEquitySecuritiesAbstract</td>
</tr>
<tr>
<td style="padding-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_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 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>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>27
<FILENAME>R10.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6814578128">
<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">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>4. &#xA0;&#xA0;&#xA0;&#xA0;Accounts Receivable and Net
 Revenue:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Accounts receivable, net consists of the following (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="65%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Gross accounts receivable</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">2,031,341</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</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: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">(1,489,069</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">542,272</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Net revenue consists of the following (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="55%"></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: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>Years Ended
 December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net patient service revenue</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">3,067,784</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">2,915,648</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">2,760,192</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">363,369</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">315,778</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">271,886</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">215,970</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">226,886</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">151,081</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;3,647,123</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;3,458,312</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;3,183,159</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The following is a summary of our payor mix, expressed as a
 percentage of net revenue, exclusive of administrative fees and
 revenue related to management services and other, for the periods
 indicated:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center">
 <b>Years&#xA0;Ended&#xA0;December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">70</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>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Government</p>
 </td>
 <td valign="bottom">&#xA0;&#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">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">23</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other third-parties</p>
 </td>
 <td valign="bottom">&#xA0;&#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>
 <td valign="bottom" align="right">6</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 <font style="WHITE-SPACE: nowrap">Private-pay</font>&#xA0;patients</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <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>
 <td valign="bottom" align="right">1</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Accounts receivable of $542.3&#xA0;million and $504.0&#xA0;million
 at December&#xA0;31, 2018 and 2017, respectively, consist primarily
 of amounts due from GHC Programs and third-party insurance payors
 for services provided by the Company&#x2019;s affiliated
 physicians.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Net revenue of $3.6&#xA0;billion, $3.5&#xA0;billion and
 $3.2&#xA0;billion for the years ended December&#xA0;31, 2018, 2017
 and 2016, respectively, consists primarily of gross billed charges
 for services provided by the Company&#x2019;s affiliated physicians
 less an estimated allowance for contractual adjustments and
 uncollectibles to properly account for the anticipated differences
 between gross billed charge amounts and expected reimbursement
 amounts.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company&#x2019;s contractual adjustments and uncollectibles as a
 percentage of gross patient service revenue vary slightly each year
 depending on several factors, including improved managed care
 contracting, changes in reimbursement from state Medicaid programs
 and other GHC Programs, shifts in the percentage of patient
 services being reimbursed under GHC Programs and annual price
 increases.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company&#x2019;s annual price increases typically increase
 contractual adjustments as a percentage of gross patient service
 revenue. This increase is primarily due to Medicaid, Medicare and
 other GHC Programs that generally provide for reimbursements on
 a&#xA0;<font style="WHITE-SPACE: nowrap">fee-schedule</font>&#xA0;basis
 rather than on a gross charge basis. When the Company bills these
 programs, like other payors, on a gross-charge basis, it also
 increases its provision for contractual adjustments and
 uncollectibles by the amount of any price increase, resulting in a
 higher contractual adjustment percentage.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 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: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 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>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_AccountsReceivableAndNetRevenueDisclosureTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 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>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ 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_AccountsReceivableAndNetRevenueDisclosureTextBlock</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>nonnum:textBlockItemType</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_TextBlockAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_TextBlockAbstract</td>
</tr>
<tr>
<td style="padding-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>28
<FILENAME>R11.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823130336">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Property and Equipment<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_PropertyPlantAndEquipmentAbstract', window );"><strong>Property, Plant and Equipment [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_PropertyPlantAndEquipmentDisclosureTextBlock', window );">Property and Equipment</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>5.&#xA0;&#xA0;&#xA0;&#xA0;Property and Equipment:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Property and equipment consists of the following (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="69%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Building</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">33,189</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">33,024</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Land</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,683</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,683</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Equipment and other</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">300,981</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">253,453</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">340,853</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">293,160</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accumulated depreciation</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(207,816</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(169,624</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">133,037</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">123,536</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 At December&#xA0;31, 2018 and 2017, property and equipment includes
 medical and other equipment held under capital leases of
 $4.8&#xA0;million and $6.1&#xA0;million, and related accumulated
 depreciation of $4.0&#xA0;million and $4.6&#xA0;million,
 respectively. The Company recorded depreciation expense of
 $38.5&#xA0;million, $33.9&#xA0;million and $29.0&#xA0;million for
 the years ended December&#xA0;31, 2018, 2017 and 2016,
 respectively.</p>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentAbstract</td>
</tr>
<tr>
<td style="padding-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_PropertyPlantAndEquipmentDisclosureTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for long-lived, physical assets used in the normal conduct of business and not intended for resale. Includes, but is not limited to, accounting policies and methodology, roll forwards, depreciation, depletion and amortization expense, including composite depreciation, accumulated depreciation, depletion and amortization expense, useful lives and method used, income statement disclosures, assets held for sale and public utility disclosures.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -URI http://asc.fasb.org/topic&amp;trid=2155823<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentDisclosureTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>29
<FILENAME>R12.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6769300720">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Business Acquisitions<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_BusinessCombinationsAbstract', window );"><strong>Business Combinations [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_BusinessCombinationDisclosureTextBlock', window );">Business Acquisitions</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>6.&#xA0;&#xA0;&#xA0;&#xA0;Business Acquisitions:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 During the year ended December&#xA0;31, 2018, the Company completed
 nine physician group practice acquisitions, including five
 radiology practices, two neonatology practices and two other
 pediatric subspecialty practices. The acquisition-date fair value
 of the total consideration for the nine acquisitions was
 $111.8&#xA0;million, net of cash acquired. In connection with these
 acquisitions, the Company recorded goodwill of $95.0&#xA0;million,
 other intangible assets consisting primarily of physician and
 hospital agreements of $17.2&#xA0;million, current assets of
 $1.7&#xA0;million and other liabilities of $2.1&#xA0;million.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 These acquisitions expanded the Company&#x2019;s national network of
 physician practices. The Company expects to improve the results of
 physician practices through improved managed care contracting,
 improved collections and identification of growth initiatives, as
 well as operating and cost savings based on the significant
 infrastructure it has developed. With respect to the
 Company&#x2019;s acquisition of radiology physician practices, the
 Company believes that it brings a unique value proposition to
 radiology physician groups, in that the Company can provide
 practice management support and a technology platform enabling
 radiology to be practiced at a national level, as well as
 teleradiology capabilities that can enhance a physician
 group&#x2019;s efficiency, provide subspecialty access and help them
 to grow strategically and remain competitive while meeting the
 demands of their hospital partners, third-party payors and
 regulatory bodies. In addition, the Company believes that radiology
 physician group practice physicians can complement the staffing
 needs for its teleradiology services business during certain times,
 such as nights and weekends, when such physicians are not providing
 services at their practices.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 During the year ended December&#xA0;31, 2018, in connection with
 certain prior-period acquisitions, the Company paid
 $6.4&#xA0;million for contingent consideration and
 $1.2&#xA0;million for purchase consideration that had been held
 back pending satisfaction of certain conditions. Of these amounts,
 all except for the accretion recorded during 2018 were accrued as
 of December&#xA0;31, 2017. In addition, the Company recorded a
 decrease of $5.3&#xA0;million related to the change in the fair
 value of a contingent consideration agreement for which the
 probability of the achievement of certain performance measures was
 updated. This change in fair value of contingent consideration was
 recorded within operating expenses.</p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 In connection with certain prior-period acquisitions, the Company
 also recorded a net increase in goodwill of $4.0&#xA0;million
 composed of a decrease in current assets of $1.2&#xA0;million, a
 decrease in noncurrent assets of $1.5&#xA0;million and a decrease
 in liabilities of $0.2&#xA0;million for measurement-period
 adjustments resulting from the finalization of acquisition
 accounting as well as additional cash consideration of
 $1.5&#xA0;million related to a working capital true up.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 On November&#xA0;1, 2018, the Company announced the initiation of a
 process to potentially divest the Company&#x2019;s management
 services service line to allow the Company to focus the
 organization on its core physician services business. There can be
 no assurance that this process will result in a transaction, and
 the Company may decide to retain all or part of the management
 services service line. The Company had expected that the management
 services service line could be classified as assets and liabilities
 held for sale within the Company&#x2019;s Consolidated Balance
 Sheets and that historical operating results of the service line
 could be reported as discontinued operations in the Company&#x2019;s
 Consolidated Statements of Income for the year ended
 December&#xA0;31, 2018; however, the criteria for such
 classification was not met at December&#xA0;31, 2018. The
 management services service line continues to be classified as held
 and used as of December&#xA0;31, 2018.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 During the year ended December&#xA0;31, 2017, the Company completed
 10 physician group practice acquisitions, including four radiology
 practices, two maternal-fetal medicine practices, one neonatology
 practice, one pediatric multi-specialty practice and two other
 pediatric subspecialty practices.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 On March&#xA0;31, 2017, the Company sold its 75% economic interest
 in a joint venture that was previously consolidated. The
 deconsolidation and removal of 100% of the carrying value of the
 joint venture&#x2019;s net assets resulted in a gain on sale that
 was not material.</p>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessCombinationDisclosureTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for a business combination (or series of individually immaterial business combinations) completed during the period, including background, timing, and recognized assets and liabilities. The disclosure may include leverage buyout transactions (as applicable).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -URI http://asc.fasb.org/topic&amp;trid=2303972<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationDisclosureTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_BusinessCombinationsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_BusinessCombinationsAbstract</td>
</tr>
<tr>
<td style="padding-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>30
<FILENAME>R13.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823147536">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Goodwill and Intangible Assets<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_GoodwillAndIntangibleAssetsDisclosureAbstract', window );"><strong>Goodwill and Intangible Assets Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock', window );">Goodwill and Intangible Assets</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>7.&#xA0;&#xA0;&#xA0;&#xA0;Goodwill and Intangible
 Assets:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Goodwill was $4.4&#xA0;billion and $4.3&#xA0;billion at
 December&#xA0;31, 2018 and 2017, respectively. The change in the
 carrying amount of goodwill of $99.0&#xA0;million during the year
 ended December&#xA0;31, 2018 is primarily related to the
 Company&#x2019;s 2018 acquisitions. The Company expects that
 $63.0&#xA0;million of the goodwill recorded during the year ended
 December&#xA0;31, 2018 will be deductible for tax purposes.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 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 December&#xA0;31, 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>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Intangible assets, net, consist of the following (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="63%"></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31, 2018</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Gross<br />
 Carrying<br />
 Value</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Accumulated<br />
 Amortization</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Net<br />
 Carrying<br />
 Value</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Physician and hospital agreements</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;376,871</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;(223,589)</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;153,282</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Customer relationships</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">443,300</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(71,870</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">371,430</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Trade names</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">43,156</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(4,630</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">38,526</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Patented and other technology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">47,561</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(22,487</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,074</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">910,888</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(322,576)</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">588,312</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="63%"></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31, 2017</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Gross<br />
 Carrying<br />
 Value</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Accumulated<br />
 Amortization</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Net<br />
 Carrying<br />
 Value</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Physician and hospital agreements</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;381,635</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;(203,915)</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;177,720</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Customer relationships</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">443,300</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(48,837</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">394,463</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Trade names</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">43,156</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2,933</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">40,223</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Patented and other technology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">38,590</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(11,068</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27,522</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">906,681</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(266,753)</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">639,928</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 During the year ended December&#xA0;31, 2018, the Company recorded
 intangible assets related to acquisitions totaling
 $17.2&#xA0;million, consisting primarily of physician and hospital
 agreements. The weighted-average amortization period for these
 physician and hospital agreements is approximately nine years.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Amortization expense for intangible assets was $72.8&#xA0;million,
 $68.9&#xA0;million and $60.3&#xA0;million for the years ended
 December&#xA0;31, 2018, 2017 and 2016, respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Amortization expense for existing intangible assets for the next
 five years is expected to be as follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0">
 <tr>
 <td width="84%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2019</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">66,532</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2020</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">59,969</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2021</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">53,771</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2022</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">46,249</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2023</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">40,448</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_GoodwillAndIntangibleAssetsDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-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_GoodwillAndIntangibleAssetsDisclosureTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for goodwill and intangible assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -URI http://asc.fasb.org/topic&amp;trid=2144416<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>31
<FILENAME>R14.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6822983376">
<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">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock', window );">Accounts Payable and Accrued Expenses</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>8.&#xA0;&#xA0;&#xA0;&#xA0;Accounts Payable and Accrued
 Expenses:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Accounts payable and accrued expenses consist of the following (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="70%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accounts payable</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">31,059</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">34,632</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrued salaries and bonuses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">249,834</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">225,429</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrued payroll taxes and benefits</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">80,369</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">75,672</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrued professional liabilities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">34,931</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">37,912</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrued contingent consideration</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">18,760</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,259</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrued interest</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">9,477</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,495</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other accrued expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">44,912</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">53,618</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">469,342</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">438,017</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for accounts payable and accrued liabilities at the end of the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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),20,24)<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_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_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>32
<FILENAME>R15.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6793094912">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accrued Professional Liabilities<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_HealthCareOrganizationsAbstract', window );"><strong>Health Care Organizations [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyDisclosureTextBlock', window );">Accrued Professional Liabilities</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>9.&#xA0;&#xA0;&#xA0;&#xA0;Accrued Professional
 Liabilities:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 At December&#xA0;31, 2018 and 2017, the Company&#x2019;s total
 accrued professional liabilities of $244.0&#xA0;million and
 $250.2&#xA0;million, respectively, included incurred but not
 reported loss reserves of $139.1&#xA0;million and
 $138.5&#xA0;million, respectively, and loss reserves for reported
 claims of $104.9&#xA0;million and $111.7&#xA0;million,
 respectively. Of the total liability, $34.9&#xA0;million is
 classified as a current liability within accounts payable and
 accrued expenses in the Consolidated Balance Sheet. In addition,
 there is a corresponding insurance receivable of $16.7&#xA0;million
 recorded as a component of other assets for certain professional
 liability claims that are covered by third-party insurance
 policies.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The activity related to the Company&#x2019;s total accrued
 professional liability for the years ended December&#xA0;31, 2018,
 2017 and 2016 is as follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="63%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>Years Ended
 December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Balance at beginning of year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">250,187</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">202,052</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">202,527</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Assumed liabilities through acquisition</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,276</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">20,716</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Provision (adjustment) for losses related to:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">34,483</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">41,291</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">38,129</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Prior years</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">10,299</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">9,983</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(25,428</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total provision for losses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">44,782</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">51,274</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">12,701</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Claim payments related to:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(555</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(712</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(766</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Prior years</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(51,699</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(23,143</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(12,410</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total payments</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(52,254</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(23,855</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(13,176</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Balance at end of year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">243,991</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">250,187</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">202,052</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The net decrease in the Company&#x2019;s total accrued professional
 liability for the year ended December&#xA0;31, 2018 was primarily
 related to an increase in claims payments made in the current year,
 partially offset by overall unfavorable trends in the
 Company&#x2019;s claims experience that impacted its provision for
 losses. The net increase in the Company&#x2019;s total accrued
 professional liability for the year ended December&#xA0;31, 2017
 was primarily related to overall unfavorable trends in the
 Company&#x2019;s claims experience that impacted its provision for
 losses and growth in the program from acquisitions.</p>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HealthCareOrganizationsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_HealthCareOrganizationsAbstract</td>
</tr>
<tr>
<td style="padding-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_MalpracticeLossContingencyDisclosureTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for the accrual for malpractice loss contingencies (general and professional liability) which may include the policy used for accruing the loss contingency, the nature and amount of any accrual, and any significant estimate used to determine the accrual.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 954<br> -SubTopic 450<br> -URI http://asc.fasb.org/subtopic&amp;trid=2289286<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyDisclosureTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>33
<FILENAME>R16.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823127984">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_DebtDisclosureAbstract', window );"><strong>Debt Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock', window );">Line of Credit, Long-Term Debt and Capital Lease Obligations</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>10.&#xA0;&#xA0;&#xA0;&#xA0;Line of Credit, Long-Term Debt and
 Capital Lease Obligations:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company&#x2019;s Credit Agreement provides for a
 $2.0&#xA0;billion unsecured revolving credit facility and includes
 a $37.5&#xA0;million&#xA0;<font style="WHITE-SPACE: nowrap">sub-facility</font>&#xA0;for the
 issuance of letters of credit. In November 2018, the Company
 amended and restated its Credit Agreement to make certain
 technical, conforming and other changes. The Credit Agreement
 matures on October&#xA0;31, 2022 and is guaranteed by substantially
 all of the Company&#x2019;s subsidiaries and affiliated professional
 associations and corporations. At the Company&#x2019;s option,
 borrowings under the Credit Agreement will bear interest at
 (i)&#xA0;the alternate base rate (defined as the higher of
 (a)&#xA0;the prime rate, (b)&#xA0;the Federal Funds Rate plus 1/2
 of 1.00% and (c)&#xA0;LIBOR for an interest period of one month
 plus 1.00%) plus an applicable margin rate ranging from 0.125% to
 0.750% based on the Company&#x2019;s consolidated leverage ratio or
 (ii)&#xA0;the LIBOR rate plus an applicable margin rate ranging
 from 1.125% to 1.750% based on the Company&#x2019;s consolidated
 leverage ratio. The Credit Agreement also calls for other customary
 fees and charges, including an unused commitment fee ranging from
 0.150% to 0.300% of the unused lending commitments, based on the
 Company&#x2019;s consolidated leverage ratio.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Credit Agreement contains customary covenants and restrictions,
 including covenants that require the Company to maintain a minimum
 interest charge ratio, not to exceed a specified consolidated
 leverage ratio and to comply with laws, and restrictions on the
 ability of the Company to pay dividends and make certain other
 distributions, as specified therein. Failure to comply with these
 covenants would constitute an event of default under the 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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 In December 2015, the Company completed a private offering of
 $750.0&#xA0;million aggregate principal amount of 2023 Notes. In
 November 2018, the Company completed a private offering of
 $500.0&#xA0;million aggregate principal amount of 2027 Notes. The
 Company&#x2019;s obligations under the 2023 Notes and the 2027 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 Notes accrues at the
 rate of 5.25% per annum and is payable semi-annually in arrears on
 June&#xA0;1 and December 1. Interest on the 2027 Notes accrues at
 the rate of 6.25% per annum and is payable semi-annually in arrears
 on January&#xA0;15 and July&#xA0;15, with the initial interest
 payment due on January&#xA0;15, 2019.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 As of December&#xA0;31, 2018, the Company may redeem all or a
 portion of the 2023 Notes, at the redemption prices of 102.625% in
 2019, 101.313% in 2020 and 100% in 2021 and thereafter, plus
 accrued and unpaid interest to the redemption date.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 At any time prior to January&#xA0;15, 2022, the Company may redeem
 all or a portion of the 2027 Notes at a redemption price equal to
 100% of the principal amount of the notes being redeemed plus an
 applicable redemption premium and accrued and unpaid interest to
 the redemption date. In addition, at any time prior to
 January&#xA0;15, 2022, the Company may redeem up to 35% of the
 aggregate principal amount of the 2027 Notes at a redemption price
 of 106.250% of the principal amount thereof, plus accrued and
 unpaid interest, if any, to the redemption date, using proceeds
 from one or more equity offerings. On or after January&#xA0;15,
 2022, the Company may redeem all or a portion of the 2027 Notes, at
 the redemption prices of 104.688% in 2022, 103.125% in 2023,
 101.563% in 2024 and 100% in 2025 and thereafter, plus accrued and
 unpaid interest to the redemption date.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The indenture under which the 2023 Notes and the 2027 Notes are
 issued, among other things, limits our ability to (1)&#xA0;incur
 liens and (2)&#xA0;enter into sale and lease-back transactions, and
 also limits our ability to merge or dispose of all or substantially
 all of our assets, in all cases, subject to a number of customary
 exceptions. Although we are not required to make mandatory
 redemption or sinking fund payments with respect to the 2023 Notes
 or the 2027 Notes, upon the occurrence of a change in control of
 MEDNAX, we may be required to repurchase the 2023 Notes or the 2027
 Notes at a purchase price equal to 101% of the aggregate principal
 amount of the 2023 Notes and the 2027 Notes repurchased plus
 accrued and unpaid interest.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The carrying value of the Company&#x2019;s long-term debt was
 $2.0&#xA0;billion and $1.8&#xA0;billion at December&#xA0;31, 2018
 and 2017, respectively, and consisted of the following (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="56%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31, 2018</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Principal</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Unamortized<br />
 Debt<br />
 Issuance<br />
 Costs</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Total</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Senior Notes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,250,000</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(15,408</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,234,592</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Revolving line of credit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">739,500</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(4,274</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">735,226</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,989,500</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(19,682</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,969,818</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="56%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31, 2017</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Principal</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Unamortized<br />
 Debt<br />
 Issuance<br />
 Costs</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Total</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Senior Notes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">750,000</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(9,503</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">740,497</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Revolving line of credit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,110,500</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(4,864</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,105,636</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,860,500</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(14,367</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,846,133</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company presents issuance costs related to long-term debt
 liabilities, other than revolving credit arrangements, as a direct
 deduction from the carrying value of that long-term debt. The
 Company has outstanding letters of credit which reduced the amount
 available under the Credit Agreement by $0.2&#xA0;million at
 December&#xA0;31, 2018. At December&#xA0;31, 2018, the Company had
 an available balance on its Credit Agreement of
 $1.3&#xA0;billion.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The carrying values of the Company&#x2019;s variable rate revolving
 line of credit approximates fair value due to the short-term nature
 of the interest rates. The estimated fair value of the
 Company&#x2019;s 2023 Notes and 2027 Notes were estimated using
 trading prices as of December&#xA0;31, 2018 and 2017, respectively,
 as Level&#xA0;2 inputs to estimate fair value and are summarized as
 follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="70%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2023 Notes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">736,725</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">763,125</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2027 Notes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">482,500</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap"><b>&#xA0;</b></td>
 <td valign="bottom" nowrap="nowrap" align="right">
 <b>&#x2014;&#xA0;&#xA0;</b></td>
 <td valign="bottom" nowrap="nowrap"><b>&#xA0;</b></td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company&#x2019;s capital lease obligations consist of the
 following (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="76%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Capital lease obligations</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">441</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,826</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Less: Current portion</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(253</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(1,401</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Long-term portion</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">188</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">425</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The amounts due under the terms of the Company&#x2019;s capital
 lease obligations at December&#xA0;31, 2018 are as follows:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0">
 <tr>
 <td width="89%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2019</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">253</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2020</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">114</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2021</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">74</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for debt and capital lease obligations can be reported. Information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants. Also includes descriptions and amounts of capital leasing arrangements that consist of direct financing, sales type and leveraged leases. Disclosure may include the effect on the balance sheet and the income statement resulting from a change in lease classification for leases that at inception would have been classified differently had guidance been in effect at the inception of the original lease.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -URI http://asc.fasb.org/topic&amp;trid=2208923<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 470<br> -URI http://asc.fasb.org/topic&amp;trid=2208564<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtAndCapitalLeasesDisclosuresTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_DebtDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>34
<FILENAME>R17.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6793094912">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxDisclosureTextBlock', window );">Income Taxes</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>11.&#xA0;&#xA0;&#xA0;&#xA0;Income Taxes:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The components of the income tax provision (benefit) are as follows
 (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="63%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Federal:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">97,754</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">130,053</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">166,758</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(20,176</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(63,038</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">15,596</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">77,578</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">67,015</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">182,354</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 State:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,605</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">20,070</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,296</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(3,973</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,965</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,553</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">22,632</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">23,035</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,849</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">100,210</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">90,050</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">189,203</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company files its tax return on a consolidated basis with its
 subsidiaries, and its affiliated professional contractors file tax
 returns on an individual basis.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Beginning on January&#xA0;1, 2018, the Company&#x2019;s statutory
 tax rate was reduced from 35.0% to 21.0% as a result of legislation
 enacted under the Tax Cuts and Jobs Act of 2017
 (&#x201C;TCJA&#x201D;). The effective tax rate was 27.2%, 21.9% and
 36.8% for the years ended December&#xA0;31, 2018, 2017 and 2016,
 respectively. During the three months ended December&#xA0;31, 2017,
 the Company recorded a $70.0&#xA0;million income tax benefit
 related to the reduction of its net deferred tax liability
 resulting from the reduction in the corporate tax rate under the
 TCJA. During the three months ended September&#xA0;30, 2016, the
 Company settled a certain tax matter with a taxing authority. In
 connection with this settlement, the Company&#x2019;s effective
 income tax rate was favorably impacted by $10.6&#xA0;million.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The differences between the effective rate and the United States
 federal income tax statutory rate are as follows:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Tax at statutory rate</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">21.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 State income tax, net of federal benefit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4.80</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3.33</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2.94</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 <font style="WHITE-SPACE: nowrap">Non-deductible</font>&#xA0;expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.44</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.49</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.43</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in accrual estimates relating to uncertain tax positions</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.05</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.02</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2.11</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in valuation allowance</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.48</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other, net</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1.20</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.16</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.06</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in tax law</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(0.32</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17.06</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax provision</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27.17</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">21.94</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">36.80</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 All of the Company&#x2019;s deferred tax assets and liabilities are
 classified as long-term. The significant components of deferred
 income tax assets and liabilities are as follows (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="69%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Allowance for uncollectible accounts</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">194,876</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">80,056</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Reserves and accruals</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">59,270</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">45,454</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Stock-based compensation</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">9,201</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">7,975</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net operating loss carryforward</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,226</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">28,569</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Property and equipment</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">685</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,197</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">970</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred tax assets before valuation allowance</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">289,796</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">163,709</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Less: Valuation allowance</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2,628</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2,615</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred tax assets, net of valuation allowance</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">287,168</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">161,094</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Gross deferred tax liabilities:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Amortization</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(286,552</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(258,618</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accounting method changes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(109,418</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(4,150</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrual to cash adjustment</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(39</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(31,290</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(489</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total deferred tax liabilities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(396,498</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(294,058</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net deferred tax liability</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(109,330</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(132,964</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company&#x2019;s net deferred tax liability decreased by
 $23.6&#xA0;million during 2018. During 2018, certain of the
 Company&#x2019;s affiliated professional contractors elected to
 change their method of accounting from cash basis to accrual basis
 for income tax purposes. During the year ended December&#xA0;31,
 2018, the increases in allowance for uncollectible accounts of
 $114.8&#xA0;million and accounting method changes of
 $105.3&#xA0;million as well as the decrease in accrual to cash
 adjustment of $31.3&#xA0;million primarily relate to these
 accounting method changes.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Beginning January&#xA0;1, 2017, excess tax benefits or deficiencies
 associated with the exercise of stock options, the vesting of
 restricted and deferred stock and the purchase of shares under the
 Company&#x2019;s&#xA0;<font style="WHITE-SPACE: nowrap">non-qualified</font>&#xA0;employee
 stock purchase plan are recognized as income tax benefits or
 expenses in the income statement in the reporting period in which
 they occur instead of an increase or decrease to
 additional&#xA0;<font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">paid-in-capital.</font></font>&#xA0;For
 the years ended December&#xA0;31, 2018 and 2017, income tax expense
 of $1.4&#xA0;million and $0.2&#xA0;million, respectively, was
 recognized for excess tax deficiencies. For the year ended
 December&#xA0;31, 2016, additional&#xA0;<font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">paid-in-capital</font></font>&#xA0;was
 increased by $4.2&#xA0;million for excess tax benefits.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company has net operating loss carryforwards for federal and
 state tax purposes totaling $101.9&#xA0;million,
 $116.0&#xA0;million and $130.0&#xA0;million at December&#xA0;31,
 2018, 2017 and 2016, respectively. With respect to the
 December&#xA0;31, 2018 balance, approximately $74.3&#xA0;million
 expires at various times from 2019 through 2038, and
 $27.6&#xA0;million does not expire.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 As of December&#xA0;31, 2018, 2017 and 2016, the Company&#x2019;s
 liability for uncertain tax positions, excluding accrued interest
 and penalties, was $11.2&#xA0;million, $11.0&#xA0;million and
 $9.5&#xA0;million, respectively. As of December&#xA0;31, 2018, the
 Company had $10.9&#xA0;million of uncertain tax positions that, if
 recognized, would favorably impact its effective tax rate.</p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The following table summarizes the activity related to the
 Company&#x2019;s liability for uncertain tax positions for the years
 ended December&#xA0;31, 2018, 2017 and 2016 (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="66%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>Years Ended
 December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Balance at beginning of year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">10,972</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">9,469</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">18,447</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Increases related to prior year tax positions</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">385</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,284</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">301</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Decreases related to prior year tax positions</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">(143</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(3,927</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Increases related to current year tax positions</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,900</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,430</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,258</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Settlements</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" 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">(5,644</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Decreases related to lapse of statutes of limitation</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(3,072</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2,068</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(1,966</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Balance at end of year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">11,185</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">10,972</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">9,469</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 During the years ended December&#xA0;31, 2018 and 2017, the Company
 increased its liability for uncertain tax positions by a total of
 $0.2&#xA0;million and $1.5&#xA0;million, respectively, primarily
 related to additional taxes on current and prior year positions,
 partially offset by the expiration of statutes of limitation. In
 addition, the Company anticipates that its liability for uncertain
 tax positions will increase by $0.2&#xA0;million over the next 12
 months.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company includes interest and penalties related to income tax
 liabilities in income tax expense. The income tax benefit
 recognized by the Company for interest and penalties during the
 year ended December&#xA0;31, 2018 was nominal. The Company
 recognized income tax benefits of $0.2&#xA0;million and
 $7.9&#xA0;million related to interest and penalties during the
 years ended December&#xA0;31, 2017 and 2016, respectively. At
 December&#xA0;31, 2018 and 2017, the Company&#x2019;s accrued
 liability for interest and penalties related to income tax
 liabilities totaled $1.1&#xA0;million and $1.2&#xA0;million,
 respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company is currently subject to U.S. Federal and various state
 income tax examinations for the tax years 2014 through 2017.</p>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxDisclosureTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -URI http://asc.fasb.org/topic&amp;trid=2144680<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>35
<FILENAME>R18.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823044480">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common and Common Equivalent Shares<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_EarningsPerShareTextBlock', window );">Common and Common Equivalent Shares</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>12. &#xA0;&#xA0;&#xA0;&#xA0;Common and Common Equivalent
 Shares:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The calculation of shares used in the basic and diluted net income
 per share calculation for the years ended December&#xA0;31, 2018,
 2017 and 2016 is as follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="73%"></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>Years Ended
 December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 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">91,104</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,431</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,422</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 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">502</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">527</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">687</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 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">91,606</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,958</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,109</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 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">214</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">107</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</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_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_EarningsPerShareTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for earnings per share.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EarningsPerShareTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>36
<FILENAME>R19.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823177520">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Stock Incentive Plans and Stock Purchase Plans<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract', window );"><strong>Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock', window );">Stock Incentive Plans and Stock Purchase Plans</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>13. &#xA0;&#xA0;&#xA0;&#xA0;Stock Incentive Plans and Stock
 Purchase Plans:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Under the Amended and Restated 2008 Incentive Plan, options to
 purchase shares of common stock may be granted at a price not less
 than the fair market value of the shares on the date of grant. The
 options must be exercised within 10 years from the date of grant
 and generally become exercisable on a pro rata basis over a
 three-year period from the date of grant. The Company issues new
 shares of its common stock upon exercise of its stock options.
 Restricted stock awards generally vest over periods of three years
 upon the fulfillment of specified service-based conditions and in
 certain instances performance-based conditions. Deferred stock
 awards generally vest upon the satisfaction of specified
 performance-based conditions or service-based conditions. The
 Company recognizes compensation expense related to its restricted
 stock and deferred stock awards ratably over the corresponding
 vesting periods. At December&#xA0;31, 2018, the Company had
 2.0&#xA0;million shares available for future grants and awards
 under its Amended and Restated 2008 Incentive Plan.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Under the Company&#x2019;s 1996&#xA0;<font style="WHITE-SPACE: nowrap">Non-Qualified</font>&#xA0;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&#xA0;<font style="WHITE-SPACE: nowrap">Non-Qualified</font>&#xA0;Stock
 Purchase Plan (the &#x201C;SPP&#x201D;), certain
 eligible&#xA0;<font style="WHITE-SPACE: nowrap">non-employee</font>&#xA0;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="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Each of the ESPP and the SPP provide for the issuance of an of
 aggregate 2.6&#xA0;million shares of the Company&#x2019;s common
 stock less the number of shares of common stock purchased under the
 other plan. The Company recognizes stock-based compensation expense
 for the discount received by participating employees
 and&#xA0;<font style="WHITE-SPACE: nowrap">non-employee</font>&#xA0;service
 providers. During the year ended December&#xA0;31, 2018,
 0.4&#xA0;million shares were issued under the ESPP and SPP. At
 December&#xA0;31, 2018, the Company had 1.6&#xA0;million shares in
 aggregate reserved for issuance under the ESPP and SPP.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company recognized $38.7&#xA0;million, $29.6&#xA0;million and
 $34.0&#xA0;million of stock-based compensation expense related to
 its stock incentive plans, the ESPP and the SPP during the years
 ended December&#xA0;31, 2018, 2017 and 2016, respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The activity related to the Company&#x2019;s restricted stock and
 deferred stock awards and the corresponding weighted average
 grant-date fair values for the year ended December&#xA0;31, 2018
 are as follows:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="68%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Number of</b><br />
 <b>Shares</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Weighted<br />
 Average&#xA0;Fair<br />
 Value</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 <font style="WHITE-SPACE: nowrap">Non-vested</font>&#xA0;shares at
 January&#xA0;1, 2018</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,041,034</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">60.21</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Awarded</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">770,480</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">51.99</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Forfeited</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(69,293</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">56.65</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Vested</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(431,368</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">63.57</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 <font style="WHITE-SPACE: nowrap">Non-vested</font>&#xA0;shares at
 December&#xA0;31, 2018</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,310,853</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">54.46</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The aggregate fair value of the restricted and deferred stock that
 vested during the years ended December&#xA0;31, 2018, 2017 and 2016
 was $27.4&#xA0;million, $29.3&#xA0;million and $29.8&#xA0;million,
 respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The weighted average grant-date fair value of restricted and
 deferred stock awards that were granted during the years ended
 December&#xA0;31, 2018, 2017 and 2016 was $51.99, $54.22 and
 $67.90, respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 At December&#xA0;31, 2018, the total stock-based compensation cost
 related to&#xA0;<font style="WHITE-SPACE: nowrap">non-vested</font>&#xA0;restricted
 and deferred stock remaining to be recognized as compensation
 expense over a weighted-average period of 1.4 years was
 $30.8&#xA0;million.</p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company did not grant any stock options in 2018, 2017, or 2016,
 and all stock-based compensation cost related to stock options has
 been recognized. The activity and certain other information related
 to the Company&#x2019;s outstanding stock option awards for the year
 ended December&#xA0;31, 2018 are as follows:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="51%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Number&#xA0;of</b><br />
 <b>Stock&#xA0;Options</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Weighted</b><br />
 <b>Average</b><br />
 <b>Exercise</b><br />
 <b>Price</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Weighted<br />
 Average<br />
 Remaining<br />
 Contractual<br />
 Term</b><br />
 <b>(in years)</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Aggregate<br />
 Intrinsic</b><br />
 <b>Value</b><br />
 <b>(in<br />
 millions)</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Outstanding at January&#xA0;1, 2018</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">246,342</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">27.51</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Exercised</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(133,366</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">27.38</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">2.8</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Outstanding and exercisable at December&#xA0;31, 2018</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">112,976</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">27.65</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1.3</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.7</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The aggregate intrinsic value of stock options exercised during the
 years ended December&#xA0;31, 2018, 2017 and 2016 was
 $2.8&#xA0;million, $5.5&#xA0;million and $6.8&#xA0;million,
 respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 There were no excess tax benefits recognized in
 additional&#xA0;<font style="WHITE-SPACE: nowrap">paid-in</font>&#xA0;capital in
 2018 or 2017 due to the adoption of new accounting guidance on
 January&#xA0;1, 2017 that requires excess tax benefits to be
 recognized in the income statement. The net excess tax benefit
 recognized in additional&#xA0;<font style="WHITE-SPACE: nowrap">paid-in</font>&#xA0;capital
 related primarily to stock options, restricted stock and deferred
 stock for the year ended December&#xA0;31, 2016 was
 $4.1&#xA0;million. The cash proceeds received from the exercise of
 stock options for the years ended December&#xA0;31, 2018, 2017 and
 2016 were $3.7&#xA0;million, $4.8&#xA0;million and
 $4.7&#xA0;million, respectively.</p>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 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>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>37
<FILENAME>R20.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823147536">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common Stock Repurchase Programs<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_CommonStockRepurchasesTextBlock', window );">Common Stock Repurchase Programs</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>14. &#xA0;&#xA0;&#xA0;&#xA0;Common Stock Repurchase
 Programs:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 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&#xA0;<font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">time-to-time</font></font>&#xA0;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. 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.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 In August 2018, the Company announced that its Board of Directors
 had authorized the repurchase of up to $500.0&#xA0;million of the
 Company&#x2019;s common stock in addition to its existing share
 repurchase program. As part of this repurchase program, on
 August&#xA0;31, 2018, the Company entered into an uncollared
 accelerated share repurchase (&#x201C;ASR&#x201D;) agreement with an
 investment bank. Under the ASR agreement, the Company agreed to
 purchase $250.0&#xA0;million of its common stock in total. On
 September&#xA0;4, 2018, the Company paid a total of
 $250.0&#xA0;million to the investment bank, which in turn delivered
 to the Company approximately 4.2&#xA0;million shares of the
 Company&#x2019;s common stock in total based on the market price of
 a share of Company common stock on August&#xA0;31, 2018. The
 payment was recorded as a reduction to the respective components of
 shareholders&#x2019; equity. The ASR agreement was funded by
 borrowings under the Company&#x2019;s Credit Agreement discussed in
 Note 10. Final settlement of the ASR occurred in December 2018 with
 the delivery to the Company of approximately 1.7&#xA0;million
 additional shares of common stock. The final number of shares of
 common stock that the Company received was based upon the average
 daily volume weighted-average price of the Company&#x2019;s common
 stock during the term of the ASR agreement, less a negotiated
 discount.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Under the share repurchase programs described above, the Company
 repurchased approximately 7.0&#xA0;million shares of its common
 stock for approximately $302.2&#xA0;million during the year ended
 December&#xA0;31, 2018, 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 exercises of stock options during the second quarter of
 2018.</p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 During the year ended December&#xA0;31, 2017, the Company
 repurchased 1.0&#xA0;million shares of its common stock for
 $70.2&#xA0;million, inclusive of 38,257 shares withheld to satisfy
 minimum statutory withholding obligations of $2.1&#xA0;million in
 connection with the vesting of restricted stock.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 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>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_CommonStockRepurchasesTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Entire disclosure of common stock repurchases.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ 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_CommonStockRepurchasesTextBlock</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>nonnum:textBlockItemType</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_TextBlockAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_TextBlockAbstract</td>
</tr>
<tr>
<td style="padding-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>38
<FILENAME>R21.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6658888912">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Retirement Plans<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_CompensationAndRetirementDisclosureAbstract', window );"><strong>Retirement Benefits [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock', window );">Retirement Plans</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>15. &#xA0;&#xA0;&#xA0;&#xA0;Retirement Plans:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company maintains six qualified contributory savings plans as
 allowed under Section&#xA0;401(k) of the Internal Revenue Code and
 Section&#xA0;1165(e) of the Puerto Rico Income Tax Act of 1954 (the
 &#x201C;401(k) Plans&#x201D;). The 401(k) Plans permit participant
 contributions and allow elective and, in certain
 situations,&#xA0;<font style="WHITE-SPACE: nowrap">non-elective</font>&#xA0;Company
 contributions based on each participant&#x2019;s contribution or a
 specified percentage of eligible wages. Participants may defer a
 percentage of their annual compensation subject to the limits
 defined in the 401(k) Plans. The Company recorded expense of
 $55.8&#xA0;million, $50.7&#xA0;million and $45.2&#xA0;million for
 the years ended December&#xA0;31, 2018, 2017 and 2016,
 respectively, primarily related to the 401(k) Plans.</p>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CompensationAndRetirementDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CompensationAndRetirementDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for pension and other postretirement benefits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 715<br> -URI http://asc.fasb.org/topic&amp;trid=2235017<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>39
<FILENAME>R22.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6810339616">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Commitments and Contingencies<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_CommitmentsAndContingenciesDisclosureAbstract', window );"><strong>Commitments and Contingencies Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommitmentsAndContingenciesDisclosureTextBlock', window );">Commitments and Contingencies</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>16. &#xA0;&#xA0;&#xA0;&#xA0;Commitments and
 Contingencies:</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 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 December&#xA0;31, 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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 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>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company leases space for its regional, medical and business
 offices, storage space and temporary housing of medical staff. The
 Company also leases an aircraft. Rent expense for the years ended
 December&#xA0;31, 2018, 2017 and 2016 was $42.9&#xA0;million,
 $42.6&#xA0;million and $38.0&#xA0;million, respectively.</p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Future minimum lease payments under&#xA0;<font style="WHITE-SPACE: nowrap">non-cancelable</font>&#xA0;operating
 leases as of December&#xA0;31, 2018 are as follows (in
 thousands):<b>&#xA0;</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0">
 <tr>
 <td width="83%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2019</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">30,824</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2020</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">22,038</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2021</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">17,946</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2022</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">12,708</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2023</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">9,440</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Thereafter</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">10,522</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">103,478</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommitmentsAndContingenciesDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommitmentsAndContingenciesDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommitmentsAndContingenciesDisclosureTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 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>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommitmentsAndContingenciesDisclosureTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>40
<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) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6659313440">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Selected Quarterly Financial Information<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_QuarterlyFinancialInformationDisclosureAbstract', window );"><strong>Quarterly Financial Information Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_QuarterlyFinancialInformationTextBlock', window );">Selected Quarterly Financial Information</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 <b>17.&#xA0;&#xA0;&#xA0;&#xA0;Selected Quarterly Financial
 Information (Unaudited):</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The following tables set forth a summary of the Company&#x2019;s
 selected quarterly financial information for each of the four
 quarters ended December&#xA0;31, 2018 and 2017 (in thousands,
 except for per share data):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" align="center" border="0">
 <tr>
 <td width="64%"></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="14" align="center"><b>2018 Quarters</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>First</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Second</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Third</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Fourth</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net revenue</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">901,857</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">915,918</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">896,652</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">932,696</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Operating expenses:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice salaries and benefits</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">631,830</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">620,980</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">625,717</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">657,061</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice supplies and other operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">30,655</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">31,833</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">30,159</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">29,381</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 General and administrative expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">108,776</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">107,908</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">102,905</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">112,789</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Depreciation and amortization</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,163</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,518</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">28,709</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">29,891</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">797,424</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">787,239</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">787,490</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">829,122</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income from operations</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">104,433</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">128,679</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">109,162</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">103,574</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Investment and other income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,464</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,202</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,302</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">967</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Interest expense</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(19,935</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(21,604</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(21,782</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(25,448</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Equity in earnings of unconsolidated affiliates</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,525</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,257</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,766</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,277</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total&#xA0;<font style="WHITE-SPACE: nowrap">non-operating</font>&#xA0;expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(16,946</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(19,145</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,714</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(22,204</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income before income taxes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">87,487</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">109,534</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">90,448</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">81,370</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax provision</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(24,059</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(30,122</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(24,873</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(21,156</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">63,428</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">79,412</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">65,575</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">60,214</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Per common and common equivalent share data (1):</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.68</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.85</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.72</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.69</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.68</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.85</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.72</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.68</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Weighted average common shares:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,859</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,987</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">90,984</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">87,810</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,505</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,529</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">91,359</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">88,258</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" border="0">
 <tr style="break-inside: avoid">
 <td valign="top" width="4%" align="left">(1)</td>
 <td valign="top" align="left">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-TOP: 0pt" align="left">Basic and diluted per share amounts are computed for
 each of the periods presented. Accordingly, the sum of the
 quarterly per share amounts may not agree with the full year
 amount.</p>
 </td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" align="center" border="0">
 <tr>
 <td width="64%"></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="14" align="center"><b>2017 Quarters</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>First</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Second</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Third</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Fourth</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net revenue</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">835,597</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">842,944</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">868,951</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">910,820</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Operating expenses:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice salaries and benefits</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">572,385</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">561,418</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">586,476</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">617,455</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice supplies and other operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27,796</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">30,872</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">29,497</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">32,353</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 General and administrative expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">103,765</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">103,015</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">101,430</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">108,895</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Depreciation and amortization</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,614</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,735</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,116</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,414</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">729,560</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">721,040</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">742,519</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">785,117</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income from operations</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">106,037</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">121,904</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">126,432</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">125,703</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Investment and other income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">576</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">365</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">235</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,777</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Interest expense</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,752</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,535</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,428</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(19,844</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Equity (loss) in earnings of unconsolidated affiliate</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">797</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">689</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(240</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(294</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total&#xA0;<font style="WHITE-SPACE: nowrap">non-operating</font>&#xA0;expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(16,379</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,481</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,433</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,361</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income before income taxes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">89,658</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">104,423</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">107,999</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">108,342</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax (provision) benefit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(34,967</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(40,725</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(42,119</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27,761</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">54,691</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">63,698</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">65,880</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">136,103</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Per common and common equivalent share data (2):</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.59</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.69</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.71</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1.47</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.59</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.69</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.71</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1.46</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Weighted average common shares:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,360</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,181</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,589</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,756</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,143</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,812</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,881</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,159</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" border="0">
 <tr style="break-inside: avoid">
 <td valign="top" width="4%" align="left">(2)</td>
 <td valign="top" align="left">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-TOP: 0pt" align="left">Basic and diluted per share amounts are computed for
 each of the periods presented. Accordingly, the sum of the
 quarterly per share amounts may not agree with the full year
 amount.</p>
 </td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_QuarterlyFinancialInformationDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<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_QuarterlyFinancialInformationDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-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_QuarterlyFinancialInformationTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 entire disclosure for quarterly financial data. Includes, but is not limited to, tabular presentation of financial information for fiscal quarters, effect of year-end adjustments, and an explanation of matters or transactions that affect comparability of the information.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 270<br> -URI http://asc.fasb.org/topic&amp;trid=2126967<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_QuarterlyFinancialInformationTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>41
<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">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6833561968">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Summary of Significant Accounting Policies (Policies)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_ConsolidationPolicyTextBlock', window );">Principles of Presentation</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt">
 <b>Principles of Presentation</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The consolidated financial statements include all the accounts of
 the Company and its subsidiaries combined with the accounts of the
 affiliated professional contractors with which the Company
 currently has specific management arrangements. The Company&#x2019;s
 agreements with affiliated professional contractors provide that
 the term of the arrangements are in most cases permanent, subject
 only to termination by the Company, except in the case of gross
 negligence, fraud or bankruptcy of the Company. The Company has the
 right to receive income, both as ongoing fees and as proceeds from
 the sale of its interest in the Company&#x2019;s affiliated
 professional contractors, in an amount that fluctuates based on the
 performance of the affiliated professional contractors and the
 change in the fair value of the Company&#x2019;s interest in the
 affiliated professional contractors. The Company has exclusive
 responsibility for the provision of all <font style="WHITE-SPACE: nowrap">non-medical</font> services required for the
 <font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">day-to-day</font></font> operation and
 management of the Company&#x2019;s affiliated professional
 contractors and establishes the guidelines for the employment and
 compensation of the physicians. In addition, the agreements provide
 that the Company has the right, but not the obligation, to
 purchase, or to designate a person(s) to purchase, the stock of the
 Company&#x2019;s affiliated professional contractors for a nominal
 amount. Separately, in its sole discretion, the Company has the
 right to assign its interest in the agreements. Based upon the
 provisions of these agreements, the Company has determined that the
 affiliated professional contractors are variable interest entities
 and that the Company is the primary beneficiary as defined in the
 accounting guidance for consolidation. All significant intercompany
 and interaffiliate accounts and transactions have been
 eliminated.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 The Company is a 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.</p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock', window );">Recently Adopted Accounting Pronouncements</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Recently Adopted Accounting Pronouncements</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 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 the Company&#x2019;s 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.</p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock', window );">New Accounting Pronouncements</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>New Accounting Pronouncements</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 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 became 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 has
 accumulated all of the necessary information required to properly
 account for leases under the new guidance. The Company has
 implemented a cloud-based software application, inclusive of a
 lease administration module and an accounting module. The Company
 is in the process of finalizing workflows, business processes and
 internal controls surrounding the new lease accounting process in
 order to meet the reporting and disclosure requirements.</p>


 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UseOfEstimates', window );">Accounting Estimates and Assumptions</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Accounting Estimates and Assumptions</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The preparation of financial statements in conformity with
 accounting principles generally accepted in the United States
 (&#x201C;GAAP&#x201D;) requires management to make estimates and
 assumptions that affect the reported amounts of assets and
 liabilities and disclosure of contingent assets and liabilities at
 the date of the financial statements and the reported amounts of
 revenue and expenses during the reporting periods. Significant
 estimates and assumptions are involved in the calculation of the
 Company&#x2019;s allowance for contractual adjustments and
 uncollectibles on accounts receivable, liabilities for self-insured
 amounts and claims incurred but not reported related to the
 Company&#x2019;s professional liability risks and the fair value of
 goodwill. Actual results could differ from those estimates.</p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingPolicyPolicyTextBlock', window );">Segment Reporting</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Segment Reporting</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The results of the Company&#x2019;s operations are aggregated into a
 single reportable segment for purposes of presenting financial
 information in accordance with the accounting guidance for segment
 reporting.</p>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The following table summarizes the Company&#x2019;s net revenue by
 service line (in percentages):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center">
 <b>Years&#xA0;Ended&#xA0;December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Neonatology and other pediatric subspecialties</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">36</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">37</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">39</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Anesthesiology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">38</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">39</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Radiology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">12</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Maternal-fetal medicine</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Management services</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">5</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Pediatric cardiology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RevenueRecognitionPolicyTextBlock', window );">Revenue Recognition</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Revenue Recognition</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; 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 GHC
 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-TOP: 12pt; 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 GHC Programs and third-party
 insurance payors for such services.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; 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 GHC 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-TOP: 12pt; 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-TOP: 12pt; 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-TOP: 12pt; TEXT-INDENT: 4%">
 Accounts receivable are primarily amounts due under <font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">fee-for-service</font></font> contracts from
 third-party payors, such as insurance companies, self-insured
 employers and patients and GHC Programs geographically dispersed
 throughout the United States and its territories. Concentration of
 credit risk relating to accounts receivable is limited by the
 number, diversity and geographic dispersion of the business units
 managed by the Company, as well as by the large number of patients
 and payors, including the various governmental agencies in the
 states in which the Company provides services. Receivables from
 government agencies made up approximately 19% and 17% of net
 accounts receivable at December&#xA0;31, 2018 and 2017,
 respectively.</p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashAndCashEquivalentsPolicyTextBlock', window );">Cash and Cash Equivalents</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Cash and Cash Equivalents</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Cash equivalents are defined as all highly liquid financial
 instruments with maturities of 90 days or less from the date of
 purchase. The Company&#x2019;s cash equivalents typically consist of
 demand deposits, amounts on deposit in money market accounts, and
 funds invested in overnight repurchase agreements. Cash equivalent
 balances may, at certain times, exceed federally insured
 limits.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 Certain cash equivalents carried by the Company are subject to the
 fair value provisions of the accounting guidance for fair value
 measurements. See &#x201C;Fair Value Measurements&#x201D; below.</p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy', window );">Restricted Cash</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Restricted Cash</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Restricted cash consists of funds in escrow related to a potential
 future payment for contingent consideration for an acquisition
 completed in 2017.</p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InvestmentPolicyTextBlock', window );">Investments</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Investments</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; 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 five years.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; 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 securities.</p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentPolicyTextBlock', window );">Property and Equipment</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Property and Equipment</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Property and equipment are recorded at original purchase cost.
 Depreciation of property and equipment is computed using the
 straight-line method over the estimated useful lives of the
 underlying assets. Estimated useful lives are generally 30 years
 for buildings; three to seven years for medical equipment, computer
 equipment, software and furniture; and the lesser of the useful
 life or the remaining lease term for leasehold improvements and
 capital leases. Upon sale or retirement of property and equipment,
 the related cost and accumulated depreciation are eliminated from
 the respective accounts and any resulting gain or loss is included
 in earnings.</p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationsPolicy', window );">Business Acquisitions</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Business Acquisitions</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company accounts for all business acquisitions at fair value
 and expenses acquisition costs as they are incurred. Any
 identifiable assets acquired and liabilities assumed are recognized
 and measured at their respective fair values on the acquisition
 date. If information about facts and circumstances existing as of
 the acquisition date is incomplete at the end of the reporting
 period in which a business acquisition occurs, the Company will
 report provisional amounts for the items for which the accounting
 is incomplete. The measurement period ends once the Company
 receives sufficient information to finalize the fair values;
 however, the period will not exceed one year from the acquisition
 date. Any adjustments to provisional amounts that are identified
 during the measurement period are recognized in the reporting
 period in which the adjustment amounts are determined.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 In connection with certain acquisitions, the Company enters into
 agreements to pay additional amounts in cash or common stock based
 on the achievement of certain performance measures for up to five
 years ending after the acquisition dates. The Company measures this
 contingent consideration at fair value at the acquisition date and
 records such contingent consideration as a liability or equity on
 the Company&#x2019;s Consolidated Balance Sheets on the acquisition
 date. The fair value of each contingent consideration liability is
 remeasured at each reporting period with any change in fair value
 recognized as income or expense within operations in the
 Company&#x2019;s Consolidated Statements of Income. See Note 6 for
 more information on the Company&#x2019;s business acquisitions.</p>


 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock', window );">Goodwill and Other Intangible Assets</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Goodwill and Other Intangible Assets</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The Company records acquired assets and assumed liabilities at
 their respective fair values under the acquisition method of
 accounting. Goodwill represents the excess of purchase price over
 the fair value of the net assets acquired. Intangible assets with
 finite lives, principally physician and hospital agreements,
 customer relationships, patented technology and trade names, are
 recognized apart from goodwill at the time of acquisition based on
 the contractual-legal and separability criteria established in the
 accounting guidance. Intangible assets with finite lives are
 amortized on either an accelerated basis based on the annual
 undiscounted economic cash flows associated with the particular
 intangible asset or on a straight-line basis over their estimated
 useful lives. Intangible assets with finite lives are amortized
 over periods of one to 20 years.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 Goodwill is tested for impairment at a reporting unit level on at
 least an annual basis in accordance with the subsequent measurement
 provisions of the accounting guidance for goodwill. The Company
 defines a reporting unit based upon its management structure for
 services provided in specific regions of the United States. The
 Company early adopted new accounting guidance in 2017 that requires
 only a single-step quantitative test with any goodwill impairment
 measured as the amount by which a reporting unit&#x2019;s carrying
 value exceeds its fair value. The Company uses income and
 market-based valuation approaches to determine the fair value of
 its reporting units. These approaches focus on discounted cash
 flows and market multiples based on the Company&#x2019;s market
 capitalization to derive the fair value of a reporting unit. The
 Company also considers the economic outlook for the healthcare
 services industry and various other factors during the testing
 process, including hospital and physician contract changes, local
 market developments, changes in third-party payor payments, and
 other publicly available information. The Company completed annual
 impairment tests in the third quarter of each of 2018, 2017 and
 2016 and determined that goodwill was not impaired in any of the
 three years.</p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock', window );">Long-Lived Assets</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Long-Lived Assets</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The Company is required to evaluate long-lived assets, including
 intangible assets subject to amortization, whenever events or
 changes in circumstances indicate that the carrying value of the
 assets may not be fully recoverable. The recoverability of such
 assets is measured by a comparison of the carrying value of the
 assets to the future undiscounted cash flows before interest
 charges to be generated by the assets. If long-lived assets are
 impaired, the impairment to be recognized is measured as the excess
 of the carrying value over the fair value. Long-lived assets held
 for disposal are reported at the lower of the carrying value or
 fair value less disposal costs. The Company does not believe there
 are any indicators that would require an adjustment to such assets
 or their estimated periods of recovery at December&#xA0;31, 2018
 pursuant to current accounting standards.</p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockShareRepurchasesPolicyTextBlock', window );">Common Stock Repurchases</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Common Stock Repurchases</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company repurchases shares of its common stock as authorized
 from time to time by its Board of Directors. The Company treats
 repurchased shares of its common stock as retired as any
 repurchased shares become authorized but unissued shares. The
 reacquisition cost of repurchased shares is recorded as a reduction
 in the respective components of shareholders&#x2019; equity.</p>


 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_ProfessionalLiabilityCoveragePolicyTextBlock', window );">Professional Liability Coverage</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Professional Liability Coverage</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The Company maintains professional liability insurance policies
 with third-party insurers generally on a claims-made basis, subject
 to deductibles or self-insured retention, exclusions and other
 restrictions. The Company&#x2019;s self-insured retention under its
 professional liability insurance program is maintained primarily
 through a wholly owned captive insurance subsidiary. The Company
 records an estimate of liabilities for self-insured amounts and
 claims incurred but not reported based on an actuarial valuation
 using historical loss information, claim emergence patterns and
 various actuarial assumptions. Liabilities for claims incurred but
 not reported are not discounted.</p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxPolicyTextBlock', window );">Income Taxes</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Income Taxes</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The Company records deferred income taxes using the liability
 method, whereby deferred tax assets and liabilities are determined
 based on the difference between the financial statement and tax
 bases of assets and liabilities using enacted tax rates in effect
 for the year in which the differences are expected to reverse. If
 it is more likely than not that all or a portion of deferred tax
 assets will not be realized, a valuation allowance is provided
 against such deferred tax assets. In making such determination, the
 Company considers all available positive and negative evidence,
 including future reversals of existing taxable temporary
 differences, projected future taxable income, <font style="WHITE-SPACE: nowrap">tax-planning</font> strategies, and results
 of recent operations.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 The accounting guidance for uncertain tax positions prescribes a
 recognition threshold and measurement attribute for financial
 statement recognition and measurement of a tax position taken or
 expected to be taken in a tax return. The guidance also requires
 policy disclosures regarding penalties and interest and extensive
 disclosures regarding increases and decreases in uncertain tax
 positions as a result of tax positions taken in a current or prior
 period, settlements with taxing authorities and any lapse of an
 applicable statute of limitations. Additional qualitative
 discussion is required for any tax position that may result in a
 significant increase or decrease in uncertain tax positions within
 a <font style="WHITE-SPACE: nowrap">12-month</font> period from the
 Company&#x2019;s reporting date.</p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy', window );">Stock Incentive Plans</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Stock Incentive Plans</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The Company grants stock-based awards consisting primarily of
 restricted stock to key employees under its Amended and Restated
 2008 Incentive Compensation Plan, as amended. The Company measures
 the cost of employee services received in exchange for stock-based
 awards based on grant-date fair value and allocates the resulting
 compensation expense over the corresponding requisite service
 period using the graded vesting attribution method. The Company
 also performs analyses to estimate forfeitures of stock-based
 awards on an annual basis and adjusts the estimates as necessary
 based on the number of awards that ultimately vest.</p>
 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerSharePolicyTextBlock', window );">Net Income Per Common Share</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt">
 <b>Net Income Per Common Share</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Basic net income per common share is calculated by dividing net
 income by the weighted average number of common shares outstanding
 during the period. Diluted net income per common share is
 calculated by dividing net income by the weighted average number of
 common and potential common shares outstanding during the period.
 Potential common shares consist of outstanding restricted stock,
 deferred stock and stock options and is calculated using the
 treasury stock method. On January&#xA0;1, 2017, the Company adopted
 new accounting guidance that no longer permits the Company to
 include the assumed excess tax benefits related to the potential
 exercise or vesting of its stock-based awards in the treasury stock
 method computation.</p>
 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FairValueOfFinancialInstrumentsPolicy', window );">Fair Value Measurements</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 18pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 <b>Fair Value Measurements</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 In accordance with the accounting guidance for fair value
 measurements and disclosures, the Company carries its money market
 funds included in cash and cash equivalents at fair value. In
 accordance with the three-tier fair value hierarchy under this
 guidance, the Company determined the fair value using quoted market
 prices, a Level&#xA0;1 input as defined under the accounting
 guidance for fair value measurements. At December&#xA0;31, 2018 and
 2017, the Company&#x2019;s money market funds had a fair value of
 $0.5&#xA0;million and $9.2&#xA0;million, respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The Company also carries the cash surrender value of life insurance
 related to its deferred compensation arrangements at fair value.
 The investments underlying the life insurance contracts consist
 primarily of exchange-traded equity securities and mutual funds
 with quoted prices in active markets. In accordance with the
 three-tier fair value hierarchy, the Company determined the fair
 value using the cash surrender value of the life insurance, a
 Level&#xA0;2 input as defined under the accounting guidance for
 fair value measurements. At December&#xA0;31, 2018 and 2017, the
 Company&#x2019;s cash surrender value of life insurance had a fair
 value of $10.5&#xA0;million and $15.6&#xA0;million,
 respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 In addition, the Company carries its contingent consideration
 liabilities related to acquisitions at fair value. In accordance
 with the three-tier fair value hierarchy, the Company determined
 the fair value of its contingent consideration liabilities using
 the income approach with assumed discount rates and payment
 probabilities. The income approach uses Level&#xA0;3, or
 unobservable inputs as defined under the accounting guidance for
 fair value measurements. At December&#xA0;31, 2018 and 2017, the
 Company&#x2019;s contingent consideration liabilities had a fair
 value of $20.0&#xA0;million and $30.5&#xA0;million, respectively.
 See Note 6 for more information regarding the Company&#x2019;s
 contingent consideration liabilities.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The carrying amounts of cash equivalents, short-term investments,
 accounts receivable and accounts payable and accrued expenses
 approximate fair value due to the short maturities of the
 respective instruments. The carrying values of long-term
 investments, line of credit, variable rate long-term debt and
 capital lease obligations approximate fair value. If the
 Company&#x2019;s investments were measured at fair value, they would
 be categorized as Level&#xA0;2 in the fair value hierarchy. If the
 Company&#x2019;s line of credit was measured at fair value, it would
 be categorized as Level&#xA0;2 in the fair value hierarchy. See
 Note 10 for information regarding the fair value of the
 Company&#x2019;s 5.25% senior unsecured notes due 2023 (the
 &#x201C;2023 Notes&#x201D;) and 6.25% senior unsecured notes due 2027
 (the &#x201C;2027 Notes&#x201D;).</p>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_CommonStockShareRepurchasesPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 share repurchases policy.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_CommonStockShareRepurchasesPolicyTextBlock</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>nonnum:textBlockItemType</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_ProfessionalLiabilityCoveragePolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Professional liability coverage policy.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_ProfessionalLiabilityCoveragePolicyTextBlock</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>nonnum:textBlockItemType</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_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Recently adopted accounting pronouncements policy.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock</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>nonnum:textBlockItemType</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_AccountingPoliciesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_AccountingPoliciesAbstract</td>
</tr>
<tr>
<td style="padding-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_BusinessCombinationsPolicy">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for completed business combinations (purchase method, acquisition method or combination of entities under common control). This accounting policy may include a general discussion of the purchase method or acquisition method of accounting (including for example, the treatment accorded contingent consideration, the identification of assets and liabilities, the purchase price allocation process, how the fair values of acquired assets and liabilities are determined) and the entity's specific application thereof. An entity that acquires another entity in a leveraged buyout transaction generally discloses the accounting policy followed by the acquiring entity in determining the basis used to value its interest in the acquired entity, and the rationale for that accounting policy.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 10<br> -Section 05<br> -Paragraph 4<br> -Subparagraph (a)-(d)<br> -URI http://asc.fasb.org/extlink&amp;oid=6909625&amp;loc=d3e227-128457<br><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 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationsPolicy</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_CashAndCashEquivalentsPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for cash and cash equivalents, including the policy for determining which items are treated as cash equivalents. Other information that may be disclosed includes (1) the nature of any restrictions on the entity's use of its cash and cash equivalents, (2) whether the entity's cash and cash equivalents are insured or expose the entity to credit risk, (3) the classification of any negative balance accounts (overdrafts), and (4) the carrying basis of cash equivalents (for example, at cost) and whether the carrying amount of cash equivalents approximates fair value.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 1<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4273-108586<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(1))<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 305<br> -SubTopic 10<br> -Section 05<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6375392&amp;loc=d3e26790-107797<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CashAndCashEquivalentsPolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Entity's cash and cash equivalents accounting policy with respect to restricted balances.  Restrictions may include legally restricted deposits held as compensating balances against short-term borrowing arrangements, contracts entered into with others, or company statements of intention with regard to particular deposits; however, time deposits and short-term certificates of deposit are not generally included in legally restricted deposits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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(1)(a))<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 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://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 305<br> -SubTopic 10<br> -Section 05<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6375392&amp;loc=d3e26790-107797<br><br>Reference 5: 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 1<br> -URI http://asc.fasb.org/extlink&amp;oid=98513485&amp;loc=d3e4273-108586<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CashAndCashEquivalentsRestrictedCashAndCashEquivalentsPolicy</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_ConsolidationPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy regarding (1) the principles it follows in consolidating or combining the separate financial statements, including the principles followed in determining the inclusion or exclusion of subsidiaries or other entities in the consolidated or combined financial statements and (2) its treatment of interests (for example, common stock, a partnership interest or other means of exerting influence) in other entities, for example consolidation or use of the equity or cost methods of accounting.  The accounting policy may also address the accounting treatment for intercompany accounts and transactions, noncontrolling interest, and the income statement treatment in consolidation for issuances of stock by a subsidiary.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SX 210.3A-02)<br> -URI http://asc.fasb.org/extlink&amp;oid=27015204&amp;loc=d3e355033-122828<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section S99<br> -Paragraph 3<br> -Subparagraph (SX 210.3A-03)<br> -URI http://asc.fasb.org/extlink&amp;oid=27015204&amp;loc=d3e355100-122828<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=109239629&amp;loc=d3e5614-111684<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConsolidationPolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_EarningsPerSharePolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for computing basic and diluted earnings or loss per share for each class of common stock and participating security. Addresses all significant policy factors, including any antidilutive items that have been excluded from the computation and takes into account stock dividends, splits and reverse splits that occur after the balance sheet date of the latest reporting period but before the issuance of the financial statements.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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><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><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 4: http://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 2<br> -URI http://asc.fasb.org/extlink&amp;oid=6371337&amp;loc=d3e3630-109257<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_EarningsPerSharePolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_FairValueOfFinancialInstrumentsPolicy">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for determining the fair value of financial instruments.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 820<br> -SubTopic 10<br> -Section 60<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=7493716&amp;loc=d3e21868-110260<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=109250915&amp;loc=d3e13279-108611<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FairValueOfFinancialInstrumentsPolicy</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_GoodwillAndIntangibleAssetsPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for goodwill and intangible assets. This accounting policy also may address how an entity assesses and measures impairment of goodwill and intangible assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 2: http://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> -URI http://asc.fasb.org/extlink&amp;oid=108376223&amp;loc=d3e13816-109267<br><br>Reference 3: 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 1<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16265-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_GoodwillAndIntangibleAssetsPolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for recognizing and measuring the impairment of long-lived assets. An entity also may disclose its accounting policy for long-lived assets to be sold. This policy excludes goodwill and intangible assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section 05<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=109226317&amp;loc=d3e202-110218<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 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 360<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (SAB Topic 5.CC)<br> -URI http://asc.fasb.org/extlink&amp;oid=27011434&amp;loc=d3e125687-122742<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ImpairmentOrDisposalOfLongLivedAssetsPolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_IncomeTaxPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for income taxes, which may include its accounting policies for recognizing and measuring deferred tax assets and liabilities and related valuation allowances, recognizing investment tax credits, operating loss carryforwards, tax credit carryforwards, and other carryforwards, methodologies for determining its effective income tax rate and the characterization of interest and penalties in the financial statements.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32847-109319<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 740<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6491622&amp;loc=d3e9504-115650<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 17<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32809-109319<br><br>Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 19<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32840-109319<br><br>Reference 6: 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 25<br> -URI http://asc.fasb.org/extlink&amp;oid=84176650&amp;loc=d3e32247-109318<br><br>Reference 7: 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 28<br> -URI http://asc.fasb.org/extlink&amp;oid=84176650&amp;loc=d3e32280-109318<br><br>Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 30<br> -Section 05<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=65884525&amp;loc=d3e40913-109327<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxPolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_InvestmentPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for investments in financial assets, including marketable securities (debt and equity securities with readily determinable fair values), investments accounted for under the equity method and cost method, securities borrowed and loaned, and repurchase and resale agreements. For marketable securities, the disclosure may include the entity's accounting treatment for transfers between investment categories and how the fair values for such securities are determined. Also, for all investments, an entity may describe its policy for assessing, recognizing and measuring impairment of the investment.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB Topic 5.M)<br> -URI http://asc.fasb.org/extlink&amp;oid=65877573&amp;loc=d3e87990-122713<br><br>Reference 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 210.5-02.2,12)<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 320<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=82897076&amp;loc=d3e27290-111563<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 5: 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)(2)<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_InvestmentPolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_NewAccountingPronouncementsPolicyPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy pertaining to new accounting pronouncements that may impact the entity's financial reporting. Includes, but is not limited to, quantification of the expected or actual impact.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_PropertyPlantAndEquipmentPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for long-lived, physical assets used in the normal conduct of business and not intended for resale. Includes, but is not limited to, basis of assets, depreciation and depletion methods used, including composite deprecation, estimated useful lives, capitalization policy, accounting treatment for costs incurred for repairs and maintenance, capitalized interest and the method it is calculated, disposals and impairments.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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(a))<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 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentPolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_RevenueRecognitionPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for revenue recognition. If the entity has different policies for different types of revenue transactions, the policy for each material type of transaction is generally disclosed. If a sales transaction has multiple element arrangements (for example, delivery of multiple products, services or the rights to use assets) the disclosure may indicate the accounting policy for each unit of accounting as well as how units of accounting are determined and valued. The disclosure may encompass important judgment as to appropriateness of principles related to recognition of revenue. The disclosure also may indicate the entity's treatment of any unearned or deferred revenue that arises from the transaction.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/otherTransitionRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/otherTransitionRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18726-107790<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/otherTransitionRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18823-107790<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RevenueRecognitionPolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_SegmentReportingPolicyPolicyTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for segment reporting.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SegmentReportingPolicyPolicyTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_ShareBasedCompensationOptionAndIncentivePlansPolicy">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for stock option and stock incentive plans. This disclosure may include (1) the types of stock option or incentive plans sponsored by the entity (2) the groups that participate in (or are covered by) each plan (3) significant plan provisions and (4) how stock compensation is measured, and the methodologies and significant assumptions used to determine that measurement.</p></div>
<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 235<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -URI http://asc.fasb.org/extlink&amp;oid=84158767&amp;loc=d3e18780-107790<br><br>Reference 2: http://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 (b),(f)<br> -URI http://asc.fasb.org/extlink&amp;oid=109197908&amp;loc=d3e5070-113901<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 1<br> -URI http://asc.fasb.org/extlink&amp;oid=109197908&amp;loc=d3e5047-113901<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_ShareBasedCompensationOptionAndIncentivePlansPolicy</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_UseOfEstimates">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Disclosure of accounting policy for the use of estimates in the preparation of financial statements in conformity with generally accepted accounting principles.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6191-108592<br><br>Reference 2: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 11<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6161-108592<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6143-108592<br><br>Reference 4: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e5967-108592<br><br>Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 4<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6061-108592<br><br>Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6132-108592<br><br>Reference 7: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e5967-108592<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UseOfEstimates</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>R25.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823146160">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Summary of Significant Accounting Policies (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_ScheduleOfSegmentReportingInformationBySegmentTextBlock', window );">Schedule of Net Revenue by Service Line</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 The following table summarizes the Company&#x2019;s net revenue by
 service line (in percentages):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; font-variant-ligatures: normal; font-variant-caps: normal">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center">
 <b>Years&#xA0;Ended&#xA0;December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Neonatology and other pediatric subspecialties</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">36</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">37</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">39</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Anesthesiology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">38</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">39</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Radiology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">12</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Maternal-fetal medicine</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Management services</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">5</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Pediatric cardiology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccountingPoliciesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_AccountingPoliciesAbstract</td>
</tr>
<tr>
<td style="padding-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_ScheduleOfSegmentReportingInformationBySegmentTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the profit or loss and total assets for each reportable segment. An entity discloses certain information on each reportable segment if the amounts (a) are included in the measure of segment profit or loss reviewed by the chief operating decision maker or (b) are otherwise regularly provided to the chief operating decision maker, even if not included in that measure of segment profit or loss.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 25<br> -URI http://asc.fasb.org/extlink&amp;oid=115929826&amp;loc=d3e8813-108599<br><br>Reference 3: 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> -URI http://asc.fasb.org/extlink&amp;oid=108376223&amp;loc=d3e13816-109267<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 21<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=115929826&amp;loc=d3e8721-108599<br><br>Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 30<br> -URI http://asc.fasb.org/extlink&amp;oid=115929826&amp;loc=d3e8906-108599<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfSegmentReportingInformationBySegmentTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>43
<FILENAME>R26.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823150288">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Investments (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Investments held are summarized as follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="52%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31, 2018</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Municipal debt securities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">18,473</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">30,841</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: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Federal home loan securities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,000</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">34,393</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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">1,450</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,465</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">21,923</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">69,699</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock', window );">Schedule of Contractual Maturities of Long-Term Investments</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Contractual maturities of long-term investments are summarized as
 follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="74%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">$</td>
 <td valign="bottom" align="right">69,699</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,561</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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" 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">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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">69,699</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HeldToMaturitySecuritiesTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of 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>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_HeldToMaturitySecuritiesTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_InvestmentsClassifiedByContractualMaturityDateTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of 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>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_InvestmentsDebtAndEquitySecuritiesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_InvestmentsDebtAndEquitySecuritiesAbstract</td>
</tr>
<tr>
<td style="padding-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>44
<FILENAME>R27.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6690685248">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accounts Receivable and Net Revenue (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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 " 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: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Accounts receivable, net consists of the following (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="65%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Gross accounts receivable</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">2,031,341</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</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: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">(1,489,069</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">542,272</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DisaggregationOfRevenueTableTextBlock', window );">Schedule of Net Revenue</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Net revenue consists of the following (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="55%"></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: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>Years Ended
 December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net patient service revenue</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">3,067,784</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">2,915,648</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">2,760,192</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">363,369</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">315,778</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">271,886</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">215,970</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">226,886</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">151,081</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;3,647,123</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;3,458,312</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;3,183,159</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock', window );">Schedule of Percentage of Net Revenue</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The following is a summary of our payor mix, expressed as a
 percentage of net revenue, exclusive of administrative fees and
 revenue related to management services and other, for the periods
 indicated:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center">
 <b>Years&#xA0;Ended&#xA0;December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; 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">70</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>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Government</p>
 </td>
 <td valign="bottom">&#xA0;&#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">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">23</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other third-parties</p>
 </td>
 <td valign="bottom">&#xA0;&#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>
 <td valign="bottom" align="right">6</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 <font style="WHITE-SPACE: nowrap">Private-pay</font>&#xA0;patients</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <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>
 <td valign="bottom" align="right">1</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DisaggregationOfRevenueTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of disaggregation of revenue into categories depicting how nature, amount, timing, and uncertainty of revenue and cash flows are affected by economic factor.</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 5<br> -URI http://asc.fasb.org/extlink&amp;oid=109196051&amp;loc=SL49130545-203045<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_DisaggregationOfRevenueTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the various types of trade accounts and notes receivable and for each the gross carrying value, allowance, and net carrying value as of the balance sheet date. Presentation is categorized by current, noncurrent and unclassified receivables.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 210.5-02.3,4)<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_ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the nature of a concentration, a benchmark to which it is compared, and the percentage that the risk is to the benchmark.</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 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 21<br> -URI http://asc.fasb.org/extlink&amp;oid=109250915&amp;loc=d3e13537-108611<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=109250915&amp;loc=d3e13531-108611<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6404-108592<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 16<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6327-108592<br><br>Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 18<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6351-108592<br><br>Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 21<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6442-108592<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_TextBlockAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_TextBlockAbstract</td>
</tr>
<tr>
<td style="padding-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>45
<FILENAME>R28.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6690649072">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Property and Equipment (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_PropertyPlantAndEquipmentAbstract', window );"><strong>Property, Plant and Equipment [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_PropertyPlantAndEquipmentTextBlock', window );">Schedule of Property and Equipment</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Property and equipment consists of the following (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="69%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Building</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">33,189</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">33,024</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Land</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,683</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,683</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Equipment and other</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">300,981</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">253,453</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">340,853</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">293,160</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accumulated depreciation</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(207,816</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(169,624</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">133,037</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">123,536</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentAbstract</td>
</tr>
<tr>
<td style="padding-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_PropertyPlantAndEquipmentTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of physical assets used in the normal conduct of business and not intended for resale. Includes, but is not limited to, balances by class of assets, depreciation and depletion expense and method used, including composite depreciation, and accumulated deprecation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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><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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>46
<FILENAME>R29.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823061664">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Goodwill and Intangible Assets (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_GoodwillAndIntangibleAssetsDisclosureAbstract', window );"><strong>Goodwill and Intangible Assets Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock', window );">Summary of Intangible Assets, Net</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Intangible assets, net, consist of the following (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="63%"></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31, 2018</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Gross<br />
 Carrying<br />
 Value</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Accumulated<br />
 Amortization</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Net<br />
 Carrying<br />
 Value</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Physician and hospital agreements</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;376,871</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;(223,589)</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;153,282</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Customer relationships</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">443,300</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(71,870</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">371,430</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Trade names</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">43,156</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(4,630</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">38,526</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Patented and other technology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">47,561</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(22,487</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,074</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">910,888</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(322,576)</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">588,312</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="63%"></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31, 2017</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Gross<br />
 Carrying<br />
 Value</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Accumulated<br />
 Amortization</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Net<br />
 Carrying<br />
 Value</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Physician and hospital agreements</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;381,635</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;(203,915)</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">&#xA0;177,720</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Customer relationships</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">443,300</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(48,837</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">394,463</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Trade names</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">43,156</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2,933</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">40,223</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Patented and other technology</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">38,590</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(11,068</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27,522</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">906,681</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(266,753)</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">639,928</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock', window );">Amortization Expenses for Existing Intangible Assets for the Next Five Years</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Amortization expense for existing intangible assets for the next
 five years is expected to be as follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0">
 <tr>
 <td width="84%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2019</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">66,532</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2020</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">59,969</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2021</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">53,771</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2022</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">46,249</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2023</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">40,448</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of amortization expense of assets, excluding financial assets, that lack physical substance, having a limited useful life.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_GoodwillAndIntangibleAssetsDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_GoodwillAndIntangibleAssetsDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-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_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of assets, excluding financial assets and goodwill, lacking physical substance with a finite life, by either major class or business segment.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<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 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16265-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>47
<FILENAME>R30.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823014544">
<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">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Accounts payable and accrued expenses consist of the following (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="70%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accounts payable</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">31,059</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">34,632</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrued salaries and bonuses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">249,834</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">225,429</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrued payroll taxes and benefits</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">80,369</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">75,672</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrued professional liabilities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">34,931</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">37,912</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrued contingent consideration</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">18,760</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,259</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrued interest</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">9,477</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,495</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other accrued expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">44,912</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">53,618</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">469,342</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">438,017</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PayablesAndAccrualsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PayablesAndAccrualsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the (a) carrying value as of the balance sheet date of liabilities incurred (and for which invoices have typically been received) and payable to vendors for goods and services received that are used in an entity's business (accounts payable); (b) other payables; and (c) accrued liabilities. Examples include taxes, interest, rent and utilities. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer). An alternative caption includes accrued expenses.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>48
<FILENAME>R31.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823145472">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accrued Professional Liabilities (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_HealthCareOrganizationsAbstract', window );"><strong>Health Care Organizations [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock', window );">Schedule of Accrued Professional Liability</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The activity related to the Company&#x2019;s total accrued
 professional liability for the years ended December&#xA0;31, 2018,
 2017 and 2016 is as follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="63%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>Years Ended
 December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Balance at beginning of year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">250,187</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">202,052</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">202,527</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Assumed liabilities through acquisition</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,276</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">20,716</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Provision (adjustment) for losses related to:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">34,483</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">41,291</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">38,129</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Prior years</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">10,299</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">9,983</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(25,428</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total provision for losses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">44,782</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">51,274</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">12,701</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Claim payments related to:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(555</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(712</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(766</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Prior years</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(51,699</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(23,143</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(12,410</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total payments</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(52,254</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(23,855</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(13,176</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Balance at end of year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">243,991</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">250,187</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">202,052</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Schedule of accrued professional liability.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_ScheduleOfAccruedProfessionalLiabilityTableTextBlock</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>nonnum:textBlockItemType</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_HealthCareOrganizationsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_HealthCareOrganizationsAbstract</td>
</tr>
<tr>
<td style="padding-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>49
<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">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6791265264">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_DebtDisclosureAbstract', window );"><strong>Debt Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfDebtTableTextBlock', window );">Schedule of Long-Term Debt</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The carrying value of the Company&#x2019;s long-term debt was
 $2.0&#xA0;billion and $1.8&#xA0;billion at December&#xA0;31, 2018
 and 2017, respectively, and consisted of the following (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="56%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31, 2018</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Principal</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Unamortized<br />
 Debt<br />
 Issuance<br />
 Costs</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Total</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Senior Notes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,250,000</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(15,408</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,234,592</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Revolving line of credit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">739,500</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(4,274</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">735,226</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,989,500</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(19,682</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,969,818</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="56%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31, 2017</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Principal</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Unamortized<br />
 Debt<br />
 Issuance<br />
 Costs</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Total</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Senior Notes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">750,000</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(9,503</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">740,497</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Revolving line of credit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,110,500</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(4,864</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,105,636</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,860,500</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(14,367</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,846,133</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfEstimatedFairValueOfNotesTableTextBlock', window );">Summary of Estimated Fair Value of Notes</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The estimated fair value of the Company&#x2019;s 2023 Notes and 2027
 Notes were estimated using trading prices as of December&#xA0;31,
 2018 and 2017, respectively, as Level&#xA0;2 inputs to estimate
 fair value and are summarized as follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="70%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2023 Notes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">736,725</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">763,125</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2027 Notes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">482,500</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap"><b>&#xA0;</b></td>
 <td valign="bottom" nowrap="nowrap" align="right">
 <b>&#x2014;&#xA0;&#xA0;</b></td>
 <td valign="bottom" nowrap="nowrap"><b>&#xA0;</b></td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_ScheduleOfCapitalLeaseObligationsTableTextBlock', window );">Schedule of Capital Lease Obligations</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The Company&#x2019;s capital lease obligations consist of the
 following (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="76%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Capital lease obligations</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">441</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,826</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Less: Current portion</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(253</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(1,401</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Long-term portion</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">188</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">425</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock', window );">Schedule of Amounts Due Under Terms of Capital Lease Obligations</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The amounts due under the terms of the Company&#x2019;s capital
 lease obligations at December&#xA0;31, 2018 are as follows:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0">
 <tr>
 <td width="89%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2019</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">253</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2020</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">114</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2021</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">74</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_ScheduleOfCapitalLeaseObligationsTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Schedule of capital lease obligations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_ScheduleOfCapitalLeaseObligationsTableTextBlock</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>nonnum:textBlockItemType</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_SummaryOfEstimatedFairValueOfNotesTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Summary of Estimated Fair Value of Notes Table [Text Block]</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_SummaryOfEstimatedFairValueOfNotesTableTextBlock</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>nonnum:textBlockItemType</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_DebtDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ScheduleOfDebtTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of information pertaining to short-term and long-debt instruments or arrangements, including but not limited to identification of terms, features, collateral requirements and other information necessary to a fair presentation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfDebtTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of future minimum lease payments as of the date of the latest balance sheet presented, in aggregate and for each of the five years succeeding fiscal years, with separate deductions from the total for the amount representing executor costs, including any profit thereon, included in the minimum lease payments and for the amount of the imputed interest necessary to reduce the net minimum lease payments to present value.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfFutureMinimumLeasePaymentsForCapitalLeasesTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>50
<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">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823173968">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock', window );">Summary of Components of Income Tax Provision</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The components of the income tax provision (benefit) are as follows
 (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="63%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Federal:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">97,754</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">130,053</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">166,758</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(20,176</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(63,038</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">15,596</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">77,578</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">67,015</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">182,354</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 State:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Current</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,605</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">20,070</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,296</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(3,973</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,965</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,553</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">22,632</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">23,035</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,849</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">100,210</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">90,050</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">189,203</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock', window );">Schedule of Differences Between Effective Rate and United States Federal Income Tax Statutory Rate</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The differences between the effective rate and the United States
 federal income tax statutory rate are as follows:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="75%"></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Tax at statutory rate</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">21.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35.00</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 State income tax, net of federal benefit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4.80</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">3.33</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2.94</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 <font style="WHITE-SPACE: nowrap">Non-deductible</font>&#xA0;expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.44</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.49</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.43</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in accrual estimates relating to uncertain tax positions</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.05</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.02</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2.11</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in valuation allowance</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.48</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other, net</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1.20</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.16</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">0.06</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Change in tax law</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(0.32</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17.06</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax provision</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27.17</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">21.94</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">36.80</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 </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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock', window );">Significant Components of Deferred Income Tax Assets and Liabilities</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 All of the Company&#x2019;s deferred tax assets and liabilities are
 classified as long-term. The significant components of deferred
 income tax assets and liabilities are as follows (in
 thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="69%"></td>
 <td valign="bottom" width="6%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="6" align="center"><b>December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Allowance for uncollectible accounts</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">194,876</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">80,056</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Reserves and accruals</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">59,270</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">45,454</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Stock-based compensation</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">9,201</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">7,975</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net operating loss carryforward</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,226</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">28,569</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Property and equipment</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">685</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,197</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">970</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred tax assets before valuation allowance</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">289,796</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">163,709</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Less: Valuation allowance</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2,628</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2,615</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Deferred tax assets, net of valuation allowance</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">287,168</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">161,094</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Gross deferred tax liabilities:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Amortization</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(286,552</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(258,618</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accounting method changes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(109,418</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(4,150</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Accrual to cash adjustment</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(39</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(31,290</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Other</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(489</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom" nowrap="nowrap" align="right">
 &#x2014;&#xA0;&#xA0;</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total deferred tax liabilities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(396,498</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(294,058</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net deferred tax liability</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(109,330</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">(132,964</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SummaryOfIncomeTaxContingenciesTextBlock', window );">Schedule of Activity Related to Gross Unrecognized Tax Benefits</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The following table summarizes the activity related to the
 Company&#x2019;s liability for uncertain tax positions for the years
 ended December&#xA0;31, 2018, 2017 and 2016 (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="84%" align="center" border="0">
 <tr>
 <td width="66%"></td>
 <td valign="bottom" width="5%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="4%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>Years Ended
 December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Balance at beginning of year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">10,972</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">9,469</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">18,447</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Increases related to prior year tax positions</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">385</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,284</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">301</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Decreases related to prior year tax positions</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">(143</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(3,927</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Increases related to current year tax positions</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,900</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,430</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,258</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Settlements</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" 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">(5,644</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Decreases related to lapse of statutes of limitation</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(3,072</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(2,068</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(1,966</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Balance at end of year</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">11,185</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">10,972</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">9,469</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the components of income tax expense attributable to continuing operations for each year presented including, but not limited to: current tax expense (benefit), deferred tax expense (benefit), investment tax credits, government grants, the benefits of operating loss carryforwards, tax expense that results from allocating certain tax benefits either directly to contributed capital or to reduce goodwill or other noncurrent intangible assets of an acquired entity, adjustments of a deferred tax liability or asset for enacted changes in tax laws or rates or a change in the tax status of the entity, and adjustments of the beginning-of-the-year balances of a valuation allowance because of a change in circumstances that causes a change in judgment about the realizability of the related deferred tax asset in future years.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the components of net deferred tax asset or liability recognized in an entity's statement of financial position, including the following: the total of all deferred tax liabilities, the total of all deferred tax assets, the total valuation allowance recognized for deferred tax assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the reconciliation using percentage or dollar amounts of the reported amount of income tax expense attributable to continuing operations for the year to the amount of income tax expense that would result from applying domestic federal statutory tax rates to pretax income from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_SummaryOfIncomeTaxContingenciesTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure for tax positions taken in the tax returns filed or to be filed for which it is more likely than not that the tax position will not be sustained upon examination by taxing authorities and other income tax contingencies. Includes, but is not limited to, interest and penalties, reconciliation of unrecognized tax benefits, unrecognized tax benefits that would affect the effective tax rate, tax years that remain subject to examination by tax jurisdictions, and information about positions for which it is reasonably possible that amounts unrecognized will significantly change within 12 months.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15<br> -Subparagraph (d)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32718-109319<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 19<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32840-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SummaryOfIncomeTaxContingenciesTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>51
<FILENAME>R34.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6814705424">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common and Common Equivalent Shares (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The calculation of shares used in the basic and diluted net income
 per share calculation for the years ended December&#xA0;31, 2018,
 2017 and 2016 is as follows (in thousands):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="73%"></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="3%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="10" align="center"><b>Years Ended
 December&#xA0;31,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 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: rgb(0,0,0) 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: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>2016</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 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">91,104</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,431</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,422</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 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">502</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">527</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">687</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 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">91,606</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,958</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,109</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 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">214</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">107</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</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_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_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the weighted average number of shares used in calculating basic net earnings per share (or unit) and diluted earnings per share (or unit).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>52
<FILENAME>R35.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6807042320">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Stock Incentive Plans and Stock Purchase Plans (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract', window );"><strong>Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock', window );">Schedule of Restricted Stock and Deferred Stock Awards</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The activity related to the Company&#x2019;s restricted stock and
 deferred stock awards and the corresponding weighted average
 grant-date fair values for the year ended December&#xA0;31, 2018
 are as follows:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="76%" align="center" border="0">
 <tr>
 <td width="68%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Number of</b><br />
 <b>Shares</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Weighted<br />
 Average&#xA0;Fair<br />
 Value</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 <font style="WHITE-SPACE: nowrap">Non-vested</font>&#xA0;shares at
 January&#xA0;1, 2018</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,041,034</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">60.21</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Awarded</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">770,480</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">51.99</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Forfeited</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(69,293</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">56.65</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Vested</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(431,368</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">63.57</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 <font style="WHITE-SPACE: nowrap">Non-vested</font>&#xA0;shares at
 December&#xA0;31, 2018</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,310,853</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">54.46</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock', window );">Schedule of Activity and Certain Other Information Related to Stock Option Awards</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The activity and certain other information related to the
 Company&#x2019;s outstanding stock option awards for the year ended
 December&#xA0;31, 2018 are as follows:</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="92%" align="center" border="0">
 <tr>
 <td width="51%"></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="8%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Number&#xA0;of</b><br />
 <b>Stock&#xA0;Options</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Weighted</b><br />
 <b>Average</b><br />
 <b>Exercise</b><br />
 <b>Price</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Weighted<br />
 Average<br />
 Remaining<br />
 Contractual<br />
 Term</b><br />
 <b>(in years)</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Aggregate<br />
 Intrinsic</b><br />
 <b>Value</b><br />
 <b>(in<br />
 millions)</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Outstanding at January&#xA0;1, 2018</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">246,342</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">27.51</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Exercised</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(133,366</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">27.38</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">2.8</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Outstanding and exercisable at December&#xA0;31, 2018</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">112,976</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">27.65</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1.3</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.7</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of the number and weighted-average grant date fair value for restricted stock units that were outstanding at the beginning and end of the year, and the number of restricted stock units that were granted, vested, or forfeited during the year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(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_ScheduleOfShareBasedCompensationRestrictedStockUnitsAwardActivityTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure for stock option plans. Includes, but is not limited to, outstanding awards at beginning and end of year, grants, exercises, forfeitures, and weighted-average grant date fair value.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 (d)<br> -URI http://asc.fasb.org/extlink&amp;oid=109197908&amp;loc=d3e5070-113901<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 50<br> -Paragraph 2<br> -Subparagraph (e)<br> -URI http://asc.fasb.org/extlink&amp;oid=109197908&amp;loc=d3e5070-113901<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 (c)(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_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>53
<FILENAME>R36.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6637541264">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Commitments and Contingencies (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_CommitmentsAndContingenciesDisclosureAbstract', window );"><strong>Commitments and Contingencies Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock', window );">Schedule of Future Minimum Lease Payments under Non-Cancelable Operating Leases</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 Future minimum lease payments under&#xA0;<font style="WHITE-SPACE: nowrap">non-cancelable</font>&#xA0;operating
 leases as of December&#xA0;31, 2018 are as follows (in
 thousands):<b>&#xA0;</b></p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="68%" align="center" border="0">
 <tr>
 <td width="83%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2019</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">30,824</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2020</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">22,038</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2021</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">17,946</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2022</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">12,708</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 2023</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">9,440</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Thereafter</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">10,522</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">103,478</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommitmentsAndContingenciesDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommitmentsAndContingenciesDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of future minimum payments required in the aggregate and for each of the five succeeding fiscal years for operating leases having initial or remaining noncancelable lease terms in excess of one year and the total minimum rentals to be received in the future under noncancelable subleases as of the balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>54
<FILENAME>R37.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6819651616">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Selected Quarterly Financial Information (Tables)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
</tr>
<tr><th class="th"><div>Dec. 31, 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_QuarterlyFinancialInformationDisclosureAbstract', window );"><strong>Quarterly Financial Information Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock', window );">Summary of Company's Selected Quarterly Financial Information</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 The following tables set forth a summary of the Company&#x2019;s
 selected quarterly financial information for each of the four
 quarters ended December&#xA0;31, 2018 and 2017 (in thousands,
 except for per share data):</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" align="center" border="0">
 <tr>
 <td width="64%"></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="14" align="center"><b>2018 Quarters</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>First</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Second</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Third</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Fourth</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net revenue</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">901,857</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">915,918</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">896,652</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">932,696</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Operating expenses:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice salaries and benefits</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">631,830</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">620,980</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">625,717</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">657,061</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice supplies and other operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">30,655</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">31,833</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">30,159</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">29,381</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 General and administrative expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">108,776</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">107,908</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">102,905</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">112,789</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Depreciation and amortization</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,163</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,518</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">28,709</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">29,891</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">797,424</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">787,239</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">787,490</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">829,122</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income from operations</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">104,433</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">128,679</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">109,162</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">103,574</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Investment and other income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,464</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,202</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,302</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">967</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Interest expense</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(19,935</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(21,604</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(21,782</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(25,448</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Equity in earnings of unconsolidated affiliates</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,525</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,257</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,766</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,277</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total&#xA0;<font style="WHITE-SPACE: nowrap">non-operating</font>&#xA0;expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(16,946</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(19,145</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,714</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(22,204</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income before income taxes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">87,487</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">109,534</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">90,448</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">81,370</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax provision</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(24,059</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(30,122</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(24,873</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(21,156</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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">63,428</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">79,412</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">65,575</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">60,214</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Per common and common equivalent share data (1):</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.68</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.85</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.72</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.69</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.68</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.85</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.72</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.68</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Weighted average common shares:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,859</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,987</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">90,984</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">87,810</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,505</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,529</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">91,359</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">88,258</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: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" border="0">
 <tr style="break-inside: avoid">
 <td valign="top" width="4%" align="left">(1)</td>
 <td valign="top" align="left">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-TOP: 0pt" align="left">Basic and diluted per share amounts are computed for
 each of the periods presented. Accordingly, the sum of the
 quarterly per share amounts may not agree with the full year
 amount.</p>
 </td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0px; FONT-SIZE: 1px; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12px; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" align="center" border="0">
 <tr>
 <td width="64%"></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="14" align="center"><b>2017 Quarters</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 8pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>First</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Second</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Third</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: rgb(0,0,0) 1pt solid" valign="bottom" colspan="2" align="center"><b>Fourth</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net revenue</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">835,597</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">842,944</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">868,951</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">910,820</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Operating expenses:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice salaries and benefits</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">572,385</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">561,418</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">586,476</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">617,455</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Practice supplies and other operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27,796</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">30,872</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">29,497</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">32,353</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 General and administrative expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">103,765</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">103,015</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">101,430</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">108,895</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 5em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Depreciation and amortization</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,614</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,735</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25,116</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,414</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total operating expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">729,560</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">721,040</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">742,519</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">785,117</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income from operations</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">106,037</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">121,904</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">126,432</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">125,703</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Investment and other income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">576</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">365</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">235</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,777</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Interest expense</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,752</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,535</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,428</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(19,844</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Equity (loss) in earnings of unconsolidated affiliate</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">797</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">689</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(240</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(294</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Total&#xA0;<font style="WHITE-SPACE: nowrap">non-operating</font>&#xA0;expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(16,379</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,481</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(18,433</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(17,361</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income before income taxes</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">89,658</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">104,423</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">107,999</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">108,342</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Income tax (provision) benefit</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(34,967</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(40,725</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(42,119</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">27,761</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 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: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">54,691</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">63,698</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">65,880</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">136,103</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Per common and common equivalent share data (2):</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Net income:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.59</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.69</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.71</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1.47</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.59</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.69</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">0.71</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1.46</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 3em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Weighted average common shares:</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 <td valign="bottom"></td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid" bgcolor="#CCEEFF">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Basic</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,360</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,181</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,589</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,756</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; break-inside: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-LEFT: 7em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Diluted</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,143</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,812</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,881</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,159</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: rgb(0,0,0) 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 12pt; FONT-FAMILY: &quot;Times New Roman&quot;; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 0pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial">
 &#xA0;</p>
 <table style="FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; WORD-SPACING: 0px; BORDER-COLLAPSE: collapse; TEXT-TRANSFORM: none; ORPHANS: 2; WIDOWS: 2; LETTER-SPACING: normal; TEXT-INDENT: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial" cellspacing="0" cellpadding="0" width="100%" border="0">
 <tr style="break-inside: avoid">
 <td valign="top" width="4%" align="left">(2)</td>
 <td valign="top" align="left">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: &quot;Times New Roman&quot;; MARGIN-TOP: 0pt" align="left">Basic and diluted per share amounts are computed for
 each of the periods presented. Accordingly, the sum of the
 quarterly per share amounts may not agree with the full year
 amount.</p>
 </td>
 </tr>
 </table>


 </div><span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_QuarterlyFinancialInformationDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<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_QuarterlyFinancialInformationDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-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_ScheduleOfQuarterlyFinancialInformationTableTextBlock">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of quarterly financial data. Includes, but is not limited to, financial information for fiscal quarters, cumulative effect of a change in accounting principle and earnings per share data.</p></div>
<a 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 270<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=109225645&amp;loc=d3e1280-108306<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>nonnum:textBlockItemType</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>55
<FILENAME>R38.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6819628224">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($)<br> $ in Millions</strong></div></th>
<th class="th" colspan="2">12 Months Ended</th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1"></th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Nov. 30, 2018</div></th>
<th class="th"><div>Jan. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<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_EquityMethodInvestmentOwnershipPercentage', window );">Equity method ownership percentage in joint venture</a></td>
<td class="nump">49.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CashAndCashEquivalentsMaturityDescription', window );">Cash and cash equivalents maturity description</a></td>
<td class="text">90<span></span>
</td>
<td class="text">&#160;<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_BusinessCombinationContingentConsiderationArrangementsTimePeriod', window );">Additional amounts to be paid in cash or common stock based on achievement of performance measures within period, maximum years</a></td>
<td class="text">5 years<span></span>
</td>
<td class="text">&#160;<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_MoneyMarketFundsAtFairValue', window );">Money market funds fair value</a></td>
<td class="nump">$ 0.5<span></span>
</td>
<td class="nump">$ 9.2<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_CashSurrenderValueFairValueDisclosure', window );">Cash surrender fair value of life insurance</a></td>
<td class="nump">10.5<span></span>
</td>
<td class="nump">15.6<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_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized', window );">Contingent consideration liabilities related to acquisitions</a></td>
<td class="nump">$ 20.0<span></span>
</td>
<td class="nump">$ 30.5<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentInterestRateStatedPercentage', window );">Debt instrument interest rate</a></td>
<td class="nump">5.25%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">5.25%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember', window );">6.25% Senior Unsecured Notes Due 2027 [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_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<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_DebtInstrumentInterestRateStatedPercentage', window );">Debt instrument interest rate</a></td>
<td class="nump">6.25%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">6.25%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis=md_UnnamedCorporateJointVentureMember', window );">Unnamed Corporate Joint Venture [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<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_EquityMethodInvestmentOwnershipPercentage', window );">Equity method ownership percentage in joint venture</a></td>
<td class="nump">37.50%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</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_ConcentrationRiskByTypeAxis=us-gaap_GovernmentContractsConcentrationRiskMember', window );">Government Contracts Concentration Risk [Member] | Accounts Receivable [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Percentage of net accounts receivable</a></td>
<td class="nump">19.00%<span></span>
</td>
<td class="nump">17.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_BuildingMember', window );">Buildings [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">30 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_srt_RangeAxis=srt_MaximumMember', window );">Maximum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_LongTermInvestmentsMaturityPeriod', window );">Long-term investments maturity period, in years</a></td>
<td class="text">5 years<span></span>
</td>
<td class="text">&#160;<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_ShortTermInvestmentMaturityPeriod', window );">Short-Term investments maturity period, in years</a></td>
<td class="text">1 year<span></span>
</td>
<td class="text">&#160;<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_FiniteLivedIntangibleAssetUsefulLife', window );">Intangible assets finite lives</a></td>
<td class="text">20 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_srt_RangeAxis=srt_MaximumMember', window );">Maximum [Member] | Medical Equipment [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">7 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_srt_RangeAxis=srt_MaximumMember', window );">Maximum [Member] | Computer Equipment [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">7 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_srt_RangeAxis=srt_MaximumMember', window );">Maximum [Member] | Software and Software Development Costs [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">7 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_srt_RangeAxis=srt_MaximumMember', window );">Maximum [Member] | Furniture [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">7 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_srt_RangeAxis=srt_MinimumMember', window );">Minimum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_LongTermInvestmentsMaturityPeriod', window );">Long-term investments maturity period, in years</a></td>
<td class="text">1 year<span></span>
</td>
<td class="text">&#160;<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_FiniteLivedIntangibleAssetUsefulLife', window );">Intangible assets finite lives</a></td>
<td class="text">1 year<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_srt_RangeAxis=srt_MinimumMember', window );">Minimum [Member] | Medical Equipment [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_srt_RangeAxis=srt_MinimumMember', window );">Minimum [Member] | Computer Equipment [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_srt_RangeAxis=srt_MinimumMember', window );">Minimum [Member] | Software and Software Development Costs [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_srt_RangeAxis=srt_MinimumMember', window );">Minimum [Member] | Furniture [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SummaryOfSignificantAccountingPoliciesLineItems', window );"><strong>Summary Of Significant Accounting Policies [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentUsefulLife', window );">Property and equipment estimated useful lives, years</a></td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_BusinessCombinationContingentConsiderationArrangementsTimePeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Business combination, contingent consideration arrangements, time period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_BusinessCombinationContingentConsiderationArrangementsTimePeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_CashAndCashEquivalentsMaturityDescription">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Cash and cash equivalents maturity description.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_CashAndCashEquivalentsMaturityDescription</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_LongTermInvestmentsMaturityPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Long term investments maturity period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_LongTermInvestmentsMaturityPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_MoneyMarketFundsAtFairValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Money market funds at fair value.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_MoneyMarketFundsAtFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_ShortTermInvestmentMaturityPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Short term investment maturity period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_ShortTermInvestmentMaturityPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_SummaryOfSignificantAccountingPoliciesLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Summary of significant accounting policies.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_SummaryOfSignificantAccountingPoliciesLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount, measured at acquisition-date fair value, of all liabilities assumed that arise from contingencies and were recognized by the entity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CashSurrenderValueFairValueDisclosure">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Fair value portion of the amount that could be realized under a life insurance contract or contracts owned by the entity, commonly known as corporate-owned life insurance (COLI) or bank-owned life insurance (BOLI).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CashSurrenderValueFairValueDisclosure</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ConcentrationRiskPercentage1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>For an entity that discloses a concentration risk in relation to quantitative amount, which serves as the "benchmark" (or denominator) in the equation, this concept represents the concentration percentage derived from the division.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 18<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6351-108592<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=109250915&amp;loc=d3e13531-108611<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 21<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=109250915&amp;loc=d3e13537-108611<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6404-108592<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskPercentage1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentInterestRateStatedPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Contractual interest rate for funds borrowed, under the debt agreement.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EquityMethodInvestmentOwnershipPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The percentage of ownership of common stock or equity participation in the investee accounted for under the equity method of accounting.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetUsefulLife">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Useful life of finite-lived intangible assets, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetUsefulLife</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentUsefulLife">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Useful life of long lived, physical assets used in the normal conduct of business and not intended for resale, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days. Examples include, but not limited to, land, buildings, machinery and equipment, office equipment, furniture and fixtures, and computer equipment.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentUsefulLife</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</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_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis=md_UnnamedCorporateJointVentureMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">srt_ScheduleOfEquityMethodInvestmentEquityMethodInvesteeNameAxis=md_UnnamedCorporateJointVentureMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_GovernmentContractsConcentrationRiskMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskByTypeAxis=us-gaap_GovernmentContractsConcentrationRiskMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ConcentrationRiskByBenchmarkAxis=us-gaap_AccountsReceivableMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskByBenchmarkAxis=us-gaap_AccountsReceivableMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_BuildingMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_BuildingMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<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>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_EquipmentMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_EquipmentMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_ComputerEquipmentMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_ComputerEquipmentMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_SoftwareAndSoftwareDevelopmentCostsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_SoftwareAndSoftwareDevelopmentCostsMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_FurnitureAndFixturesMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=us-gaap_FurnitureAndFixturesMember</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_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>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>56
<FILENAME>R39.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6820510816">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Summary of Significant Accounting Policies - Schedule of Net Revenue by Service Line (Detail) - Product Concentration Risk [Member] - Sales Revenue, Services, Net [Member]<br></strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">100.00%<span></span>
</td>
<td class="nump">100.00%<span></span>
</td>
<td class="nump">100.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Neonatology and Other Pediatric Subspecialties [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">36.00%<span></span>
</td>
<td class="nump">37.00%<span></span>
</td>
<td class="nump">39.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Anesthesiology [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">35.00%<span></span>
</td>
<td class="nump">38.00%<span></span>
</td>
<td class="nump">39.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Radiology And Teleradiology [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">12.00%<span></span>
</td>
<td class="nump">8.00%<span></span>
</td>
<td class="nump">6.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Maternal-Fetal Medicine [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">8.00%<span></span>
</td>
<td class="nump">8.00%<span></span>
</td>
<td class="nump">8.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Management Services [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">6.00%<span></span>
</td>
<td class="nump">6.00%<span></span>
</td>
<td class="nump">5.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember', window );">Pediatric Cardiology [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SegmentReportingInformationLineItems', window );"><strong>Segment Reporting Information [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ConcentrationRiskPercentage1', window );">Net revenue in percentage</a></td>
<td class="nump">3.00%<span></span>
</td>
<td class="nump">3.00%<span></span>
</td>
<td class="nump">3.00%<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_ConcentrationRiskPercentage1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>For an entity that discloses a concentration risk in relation to quantitative amount, which serves as the "benchmark" (or denominator) in the equation, this concept represents the concentration percentage derived from the division.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 18<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6351-108592<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=109250915&amp;loc=d3e13531-108611<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 825<br> -SubTopic 10<br> -Section 50<br> -Paragraph 21<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=109250915&amp;loc=d3e13537-108611<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -SubTopic 10<br> -Section 50<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=99393423&amp;loc=d3e6404-108592<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskPercentage1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SegmentReportingInformationLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SegmentReportingInformationLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskByTypeAxis=us-gaap_ProductConcentrationRiskMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ConcentrationRiskByBenchmarkAxis=us-gaap_SalesRevenueServicesNetMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ConcentrationRiskByBenchmarkAxis=us-gaap_SalesRevenueServicesNetMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_srt_ProductOrServiceAxis=md_NeonatologyAndOtherPediatricSubspecialtiesMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">srt_ProductOrServiceAxis=md_NeonatologyAndOtherPediatricSubspecialtiesMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</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_ProductOrServiceAxis=md_AnesthesiologyMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">srt_ProductOrServiceAxis=md_AnesthesiologyMember</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_ProductOrServiceAxis=md_RadiologyAndTeleradiologyMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">srt_ProductOrServiceAxis=md_RadiologyAndTeleradiologyMember</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_ProductOrServiceAxis=md_MaternalFetalMedicineMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">srt_ProductOrServiceAxis=md_MaternalFetalMedicineMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</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_ProductOrServiceAxis=us-gaap_ManagementServiceMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_ManagementServiceMember</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_ProductOrServiceAxis=md_PediatricCardiologyMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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=md_PediatricCardiologyMember</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>57
<FILENAME>R40.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6833194832">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Investments - Schedule of Investments (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 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">$ 21,923<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">69,699<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">18,473<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">30,841<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="nump">2,000<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">34,393<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">1,450<span></span>
</td>
<td class="nump">980<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HeldToMaturitySecuritiesNoncurrent', window );">Long-Term</a></td>
<td class="nump">$ 4,465<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>
</table>
<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>58
<FILENAME>R41.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823007296">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Investments - Schedule of Contractual Maturities of Long-Term Investments (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 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">$ 69,699<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="text">&#160;<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">$ 69,699<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>
</tr>
<tr>
<td style="padding-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_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>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>
</tr>
<tr>
<td style="padding-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_InvestmentsDebtAndEquitySecuritiesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_InvestmentsDebtAndEquitySecuritiesAbstract</td>
</tr>
<tr>
<td style="padding-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>59
<FILENAME>R42.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6690191312">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Accounts Receivable and Net Revenue - Schedule of Accounts Receivable, Net (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 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">$ 2,031,341<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">(1,489,069)<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">$ 542,272<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>
</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>60
<FILENAME>R43.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6811841776">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accounts Receivable and Net Revenue - Schedule of Net Revenue (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Sep. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Mar. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_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>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<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">$ 932,696<span></span>
</td>
<td class="nump">$ 896,652<span></span>
</td>
<td class="nump">$ 915,918<span></span>
</td>
<td class="nump">$ 901,857<span></span>
</td>
<td class="nump">$ 910,820<span></span>
</td>
<td class="nump">$ 868,951<span></span>
</td>
<td class="nump">$ 842,944<span></span>
</td>
<td class="nump">$ 835,597<span></span>
</td>
<td class="nump">$ 3,647,123<span></span>
</td>
<td class="nump">$ 3,458,312<span></span>
</td>
<td class="nump">$ 3,183,159<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_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>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<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>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<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="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">3,067,784<span></span>
</td>
<td class="nump">2,915,648<span></span>
</td>
<td class="nump">2,760,192<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>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<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>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<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="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">363,369<span></span>
</td>
<td class="nump">315,778<span></span>
</td>
<td class="nump">271,886<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 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<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>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<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="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 215,970<span></span>
</td>
<td class="nump">$ 226,886<span></span>
</td>
<td class="nump">$ 151,081<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>
</tr>
<tr>
<td style="padding-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_srt_ProductOrServiceAxis=us-gaap_HealthCarePatientServiceMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_HealthCarePatientServiceMember</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_ProductOrServiceAxis=md_HospitalsContractsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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=md_HospitalsContractsMember</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_ProductOrServiceAxis=us-gaap_ManagementServiceMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_ManagementServiceMember</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>61
<FILENAME>R44.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6833680400">
<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="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_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>
</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">100.00%<span></span>
</td>
<td class="nump">100.00%<span></span>
</td>
<td class="nump">100.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_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>
</tr>
<tr class="ro">
<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>
</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">70.00%<span></span>
</td>
<td class="nump">70.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HealthCareOrganizationRevenueSourcesAxis=us-gaap_GovernmentMember', window );">Government [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_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>
</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">24.00%<span></span>
</td>
<td class="nump">25.00%<span></span>
</td>
<td class="nump">23.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HealthCareOrganizationRevenueSourcesAxis=us-gaap_ThirdPartyPayorMember', window );">Other Third-Parties [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_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>
</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">4.00%<span></span>
</td>
<td class="nump">4.00%<span></span>
</td>
<td class="nump">6.00%<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HealthCareOrganizationRevenueSourcesAxis=us-gaap_SelfPayMember', window );">Private-Pay Patients [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_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>
</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">2.00%<span></span>
</td>
<td class="nump">1.00%<span></span>
</td>
<td class="nump">1.00%<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_PercentageOfNetPatientServiceRevenueByTypeOfPayor">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of 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>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems</td>
</tr>
<tr>
<td style="padding-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_HealthCareOrganizationRevenueSourcesAxis=md_ContractedManagedCareMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_HealthCareOrganizationRevenueSourcesAxis=md_ContractedManagedCareMember</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_HealthCareOrganizationRevenueSourcesAxis=us-gaap_GovernmentMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_HealthCareOrganizationRevenueSourcesAxis=us-gaap_GovernmentMember</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_HealthCareOrganizationRevenueSourcesAxis=us-gaap_ThirdPartyPayorMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_HealthCareOrganizationRevenueSourcesAxis=us-gaap_ThirdPartyPayorMember</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_HealthCareOrganizationRevenueSourcesAxis=us-gaap_SelfPayMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_HealthCareOrganizationRevenueSourcesAxis=us-gaap_SelfPayMember</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>62
<FILENAME>R45.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6820703504">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accounts Receivable and Net Revenue - Additional Information (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Sep. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Mar. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ReceivablesAbstract', window );"><strong>Receivables [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccountsReceivableNetCurrent', window );">Accounts receivable, net</a></td>
<td class="nump">$ 542,272<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 503,999<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 542,272<span></span>
</td>
<td class="nump">$ 503,999<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">$ 932,696<span></span>
</td>
<td class="nump">$ 896,652<span></span>
</td>
<td class="nump">$ 915,918<span></span>
</td>
<td class="nump">$ 901,857<span></span>
</td>
<td class="nump">$ 910,820<span></span>
</td>
<td class="nump">$ 868,951<span></span>
</td>
<td class="nump">$ 842,944<span></span>
</td>
<td class="nump">$ 835,597<span></span>
</td>
<td class="nump">$ 3,647,123<span></span>
</td>
<td class="nump">$ 3,458,312<span></span>
</td>
<td class="nump">$ 3,183,159<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AccountsReceivableNetCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount due from customers or clients, within one year of the balance sheet date (or the normal operating cycle, whichever is longer), for goods or services (including trade receivables) that have been delivered or sold in the normal course of business, reduced to the estimated net realizable fair value by an allowance established by the entity of the amount it deems uncertain of collection.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/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_ReceivablesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ReceivablesAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</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>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>63
<FILENAME>R46.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6763097280">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Property Plant and Equipment - Schedule of Property and Equipment (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 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_PropertyPlantAndEquipmentAbstract', window );"><strong>Property, Plant and Equipment [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BuildingsAndImprovementsGross', window );">Building</a></td>
<td class="nump">$ 33,189<span></span>
</td>
<td class="nump">$ 33,024<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_Land', window );">Land</a></td>
<td class="nump">6,683<span></span>
</td>
<td class="nump">6,683<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FixturesAndEquipmentGross', window );">Equipment and other</a></td>
<td class="nump">300,981<span></span>
</td>
<td class="nump">253,453<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentGross', window );">Property and equipment, gross</a></td>
<td class="nump">340,853<span></span>
</td>
<td class="nump">293,160<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment', window );">Accumulated depreciation</a></td>
<td class="num">(207,816)<span></span>
</td>
<td class="num">(169,624)<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentNet', window );">Property and equipment, net</a></td>
<td class="nump">$ 133,037<span></span>
</td>
<td class="nump">$ 123,536<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_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of accumulated depreciation, depletion and amortization for physical assets used in the normal conduct of business to produce goods and services.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<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 210.5-02.14)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BuildingsAndImprovementsGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before accumulated depreciation of building structures held for productive use including addition, improvement, or renovation to the structure, including, but not limited to, interior masonry, interior flooring, electrical, and plumbing.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 (f)<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 360<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BuildingsAndImprovementsGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</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_FixturesAndEquipmentGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before accumulated depreciation of fixtures and equipment. Includes, but is not limited to, machinery, equipment, and engines.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FixturesAndEquipmentGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</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_Land">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before accumulated depletion of real estate held for productive use, excluding land held for sale.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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><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 4<br> -Subparagraph (e)<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6812-107765<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_Land</td>
</tr>
<tr>
<td style="padding-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_PropertyPlantAndEquipmentAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentAbstract</td>
</tr>
<tr>
<td style="padding-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_PropertyPlantAndEquipmentGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before accumulated depreciation, depletion and amortization of physical assets used in the normal conduct of business and not intended for resale. Examples include, but are not limited to, land, buildings, machinery and equipment, office equipment, and furniture and fixtures.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<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 210.5-02.13)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after accumulated depreciation, depletion and amortization of physical assets used in the normal conduct of business to produce goods and services and not intended for resale. Examples include, but are not limited to, land, buildings, machinery and equipment, office equipment, and furniture and fixtures.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
<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>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>64
<FILENAME>R47.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6804749888">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Property and Equipment - Additional Information (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentLineItems', window );"><strong>Property, Plant and Equipment [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentGross', window );">Medical and other equipment held under capital leases</a></td>
<td class="nump">$ 340,853<span></span>
</td>
<td class="nump">$ 293,160<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_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment', window );">Accumulated depreciation of property and equipment held under capital leases</a></td>
<td class="nump">207,816<span></span>
</td>
<td class="nump">169,624<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_Depreciation', window );">Recorded depreciation expense</a></td>
<td class="nump">38,500<span></span>
</td>
<td class="nump">33,900<span></span>
</td>
<td class="nump">$ 29,000<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember', window );">Medical and Other Equipment Held under Capital Lease [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentLineItems', window );"><strong>Property, Plant and Equipment [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PropertyPlantAndEquipmentGross', window );">Medical and other equipment held under capital leases</a></td>
<td class="nump">4,800<span></span>
</td>
<td class="nump">6,100<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment', window );">Accumulated depreciation of property and equipment held under capital leases</a></td>
<td class="nump">$ 4,000<span></span>
</td>
<td class="nump">$ 4,600<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_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of accumulated depreciation, depletion and amortization for physical assets used in the normal conduct of business to produce goods and services.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<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 210.5-02.14)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_Depreciation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of expense recognized in the current period that reflects the allocation of the cost of tangible assets over the assets' useful lives. Includes production and non-production related depreciation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<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_Depreciation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before accumulated depreciation, depletion and amortization of physical assets used in the normal conduct of business and not intended for resale. Examples include, but are not limited to, land, buildings, machinery and equipment, office equipment, and furniture and fixtures.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=6391035&amp;loc=d3e2868-110229<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 210.5-02.13)<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PropertyPlantAndEquipmentByTypeAxis=md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PropertyPlantAndEquipmentByTypeAxis=md_MedicalAndOtherEquipmentHeldUnderCapitalLeaseMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</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>65
<FILENAME>R48.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6819803648">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Business Acquisitions - Additional Information (Detail)<br> $ in Millions</strong></div></th>
<th class="th" colspan="1"></th>
<th class="th" colspan="2">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th">
<div>Dec. 31, 2018 </div>
<div>USD ($) </div>
<div>Company</div>
</th>
<th class="th">
<div>Dec. 31, 2017 </div>
<div>Company</div>
</th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionLineItems', window );"><strong>Business Acquisition [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfPhysicianGroupPracticesAcquired', window );">Number of physician group practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">9<span></span>
</td>
<td class="nump">10<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfNeonatologyPracticesAcquired', window );">Number of neonatology practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">2<span></span>
</td>
<td class="nump">1<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfPediatricSubspecialtyPracticesAcquired', window );">Number of other pediatric subspecialty practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">2<span></span>
</td>
<td class="nump">2<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NumberOfRadiologyPracticesAcquired', window );">Number of radiology practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">5<span></span>
</td>
<td class="nump">4<span></span>
</td>
</tr>
<tr class="ro">
<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="text">&#160;<span></span>
</td>
<td class="nump">$ 111.8<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PaymentsForPreviousAcquisition', window );">Contingent consideration payments related to prior-period acquisitions</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">6.4<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_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions', window );">Purchase consideration payments related to prior-period acquisitions</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1.2<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_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1', window );">Change in the fair value of a contingent consideration</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(5.3)<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="text">&#160;<span></span>
</td>
<td class="nump">$ 46.0<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EquityMethodInvestmentOwnershipPercentage', window );">Sale of equity method investments</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">49.00%<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_NumberOfMaternalfetalMedicinePracticesAcquired', window );">Number of maternal-fetal medicine practices acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">2<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_NumberOfPediatricMultiSpecialtyPracticesAcquired', window );">Number of pediatric multi-specialty practice acquired | Company</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_SaleOfMinorityInterestPercentage', window );">Sale of minority interest percentage</a></td>
<td class="nump">75.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_DeconsolidationPercentage', window );">Deconsolidation percentage</a></td>
<td class="nump">100.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionAxis=md_PhysicianGroupMember', window );">Physician Group [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionLineItems', window );"><strong>Business Acquisition [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GoodwillAcquiredDuringPeriod', window );">Goodwill</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 95.0<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles', window );">Other intangible assets</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">17.2<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_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets', window );">Decrease in current assets</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1.7<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther', window );">Other liabilities</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">2.1<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionAxis=md_PriorPeriodAcquisitionsMember', window );">Prior-Period Acquisitions [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessAcquisitionLineItems', window );"><strong>Business Acquisition [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets', window );">Decrease in current assets</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1.2<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_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets', window );">Decrease in noncurrent assets</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1.5<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 );">Decrease in noncurrent liabilities</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">0.2<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="text">&#160;<span></span>
</td>
<td class="nump">4.0<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_PaymentsToAcquireBusinessesGross', window );">Additional cash consideration related to a working capital true up</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 1.5<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_DeconsolidationPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Deconsolidation percentage.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_DeconsolidationPercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfMaternalfetalMedicinePracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of maternal-fetal medicine practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfMaternalfetalMedicinePracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfNeonatologyPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of neonatology practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfNeonatologyPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfPediatricMultiSpecialtyPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of pediatric multi-specialty practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfPediatricMultiSpecialtyPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfPediatricSubspecialtyPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of other pediatric subspecialty practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfPediatricSubspecialtyPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfPhysicianGroupPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of physician group practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfPhysicianGroupPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NumberOfRadiologyPracticesAcquired">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of radiology practices acquired.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NumberOfRadiologyPracticesAcquired</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:integerItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_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_md_SaleOfMinorityInterestPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Sale of minority interest percentage.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_SaleOfMinorityInterestPercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_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_BusinessCombinationConsiderationTransferred1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of consideration transferred, consisting of acquisition-date fair value of assets transferred by the acquirer, liabilities incurred by the acquirer, and equity interest issued by the acquirer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationConsiderationTransferred1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 the value of a contingent consideration liability, including, but not limited to, differences arising upon settlement.</p></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><br>Reference 2: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 50<br> -Paragraph 4<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=35744584&amp;loc=d3e7008-128479<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_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1</td>
</tr>
<tr>
<td style="padding-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_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of assets that are expected to be realized or consumed within one year or the normal operating cycle, if longer, acquired at the acquisition date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssets</td>
</tr>
<tr>
<td style="padding-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_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles</td>
</tr>
<tr>
<td style="padding-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_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets</td>
</tr>
<tr>
<td style="padding-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_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities</td>
</tr>
<tr>
<td style="padding-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_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of other 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">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesOther</td>
</tr>
<tr>
<td style="padding-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_EquityMethodInvestmentOwnershipPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The percentage of ownership of common stock or equity participation in the investee accounted for under the equity method of accounting.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_GoodwillAcquiredDuringPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized resulting from a business combination.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 (b)<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>
<td style="white-space:nowrap;">us-gaap_GoodwillAcquiredDuringPeriod</td>
</tr>
<tr>
<td style="padding-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_GoodwillPurchaseAccountingAdjustments">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) from adjustments after acquisition date under purchase accounting of an asset representing the future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
<td style="white-space:nowrap;">us-gaap_GoodwillPurchaseAccountingAdjustments</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<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_PaymentsForPreviousAcquisition">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Cash outflow representing an adjustment to the purchase price of a previous acquisition.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>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>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PaymentsForPreviousAcquisition</td>
</tr>
<tr>
<td style="padding-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_PaymentsToAcquireBusinessesGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The cash outflow associated with the acquisition of business during the period. The cash portion only of the acquisition price.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 805<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=35744584&amp;loc=d3e6927-128479<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 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_PaymentsToAcquireBusinessesGross</td>
</tr>
<tr>
<td style="padding-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_BusinessAcquisitionAxis=md_PhysicianGroupMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessAcquisitionAxis=md_PhysicianGroupMember</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_BusinessAcquisitionAxis=md_PriorPeriodAcquisitionsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessAcquisitionAxis=md_PriorPeriodAcquisitionsMember</td>
</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>66
<FILENAME>R49.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6820459104">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_GoodwillAndOtherIntangibleAssetsLineItems', window );"><strong>Goodwill And Other Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<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">$ 4,382,995<span></span>
</td>
<td class="nump">$ 4,283,963<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_GoodwillPeriodIncreaseDecrease', window );">Change in goodwill carrying amount</a></td>
<td class="nump">99,000<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_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount', window );">Goodwill deductible for tax purpose</a></td>
<td class="nump">63,000<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_FinitelivedIntangibleAssetsAcquired1', window );">Intangible assets related to acquisitions</a></td>
<td class="nump">17,200<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AmortizationOfIntangibleAssets', window );">Amortization expense for intangible assets</a></td>
<td class="nump">$ 72,800<span></span>
</td>
<td class="nump">$ 68,900<span></span>
</td>
<td class="nump">$ 60,300<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PhysicianAndHospitalAgreementsMember', window );">Physician And Hospital Agreements [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_GoodwillAndOtherIntangibleAssetsLineItems', window );"><strong>Goodwill And Other Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife', window );">Weighted average amortization period</a></td>
<td class="text">9 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_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>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_GoodwillAndOtherIntangibleAssetsLineItems', window );"><strong>Goodwill And Other Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<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>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_GoodwillAndOtherIntangibleAssetsLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Goodwill And Other Intangible Assets [Line Items]</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_GoodwillAndOtherIntangibleAssetsLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average amortization period of finite-lived intangible assets acquired either individually or as part of a group of assets, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 1<br> -Subparagraph (a)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16265-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife</td>
</tr>
<tr>
<td style="padding-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_AmortizationOfIntangibleAssets">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate expense charged against earnings to allocate the cost of intangible assets (nonphysical assets not used in production) in a systematic and rational manner to the periods expected to benefit from such assets. As a noncash expense, this element is added back to net income when calculating cash provided by or used in operations using the indirect method.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 2: 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)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=6388964&amp;loc=d3e16225-109274<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AmortizationOfIntangibleAssets</td>
</tr>
<tr>
<td style="padding-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_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_FinitelivedIntangibleAssetsAcquired1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in assets, excluding financial assets, lacking physical substance with a definite life, from an acquisition.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 350<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16265-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FinitelivedIntangibleAssetsAcquired1</td>
</tr>
<tr>
<td style="padding-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_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_GoodwillPeriodIncreaseDecrease">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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> -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>
<td style="white-space:nowrap;">us-gaap_GoodwillPeriodIncreaseDecrease</td>
</tr>
<tr>
<td style="padding-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_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PhysicianAndHospitalAgreementsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PhysicianAndHospitalAgreementsMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</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_StatementBusinessSegmentsAxis=md_ManagementServicesReportingUnitMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_StatementBusinessSegmentsAxis=md_ManagementServicesReportingUnitMember</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>67
<FILENAME>R50.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6811864512">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Goodwill and Intangible Assets - Summary of Intangible Assets, Net (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 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_FiniteLivedIntangibleAssetsLineItems', window );"><strong>Finite-Lived Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsGross', window );">Gross Carrying Value</a></td>
<td class="nump">$ 910,888<span></span>
</td>
<td class="nump">$ 906,681<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization', window );">Accumulated Amortization</a></td>
<td class="num">(322,576)<span></span>
</td>
<td class="num">(266,753)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsNet', window );">Net Carrying Value</a></td>
<td class="nump">588,312<span></span>
</td>
<td class="nump">639,928<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PhysicianAndHospitalAgreementsMember', window );">Physician And Hospital Agreements [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsLineItems', window );"><strong>Finite-Lived Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsGross', window );">Gross Carrying Value</a></td>
<td class="nump">376,871<span></span>
</td>
<td class="nump">381,635<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization', window );">Accumulated Amortization</a></td>
<td class="num">(223,589)<span></span>
</td>
<td class="num">(203,915)<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsNet', window );">Net Carrying Value</a></td>
<td class="nump">153,282<span></span>
</td>
<td class="nump">177,720<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=us-gaap_CustomerRelationshipsMember', window );">Customer Relationships [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsLineItems', window );"><strong>Finite-Lived Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsGross', window );">Gross Carrying Value</a></td>
<td class="nump">443,300<span></span>
</td>
<td class="nump">443,300<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization', window );">Accumulated Amortization</a></td>
<td class="num">(71,870)<span></span>
</td>
<td class="num">(48,837)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsNet', window );">Net Carrying Value</a></td>
<td class="nump">371,430<span></span>
</td>
<td class="nump">394,463<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=us-gaap_TradeNamesMember', window );">Trade Names [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsLineItems', window );"><strong>Finite-Lived Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsGross', window );">Gross Carrying Value</a></td>
<td class="nump">43,156<span></span>
</td>
<td class="nump">43,156<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization', window );">Accumulated Amortization</a></td>
<td class="num">(4,630)<span></span>
</td>
<td class="num">(2,933)<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsNet', window );">Net Carrying Value</a></td>
<td class="nump">38,526<span></span>
</td>
<td class="nump">40,223<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PatentedAndOtherTechnologyMember', window );">Patented and Other Technology [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsLineItems', window );"><strong>Finite-Lived Intangible Assets [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsGross', window );">Gross Carrying Value</a></td>
<td class="nump">47,561<span></span>
</td>
<td class="nump">38,590<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization', window );">Accumulated Amortization</a></td>
<td class="num">(22,487)<span></span>
</td>
<td class="num">(11,068)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsNet', window );">Net Carrying Value</a></td>
<td class="nump">$ 25,074<span></span>
</td>
<td class="nump">$ 27,522<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Accumulated amount of amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_FiniteLivedIntangibleAssetsAccumulatedAmortization</td>
</tr>
<tr>
<td style="padding-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_FiniteLivedIntangibleAssetsGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 928<br> -SubTopic 340<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=6473545&amp;loc=d3e61844-108004<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 30<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsGross</td>
</tr>
<tr>
<td style="padding-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_FiniteLivedIntangibleAssetsLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsLineItems</td>
</tr>
<tr>
<td style="padding-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_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_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PhysicianAndHospitalAgreementsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PhysicianAndHospitalAgreementsMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</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_FiniteLivedIntangibleAssetsByMajorClassAxis=us-gaap_CustomerRelationshipsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=us-gaap_CustomerRelationshipsMember</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_FiniteLivedIntangibleAssetsByMajorClassAxis=us-gaap_TradeNamesMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=us-gaap_TradeNamesMember</td>
</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_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PatentedAndOtherTechnologyMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis=md_PatentedAndOtherTechnologyMember</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>68
<FILENAME>R51.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6810012752">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Goodwill and Intangible Assets - Amortization Expenses for Existing Intangible Assets for the Next Five Years (Detail)<br> $ in Thousands</strong></div></th>
<th class="th">
<div>Dec. 31, 2018 </div>
<div>USD ($)</div>
</th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract', window );"><strong>Goodwill and Intangible Assets Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths', window );">Amortization expense for existing other intangible assets, 2019</a></td>
<td class="nump">$ 66,532<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo', window );">Amortization expense for existing other intangible assets, 2020</a></td>
<td class="nump">59,969<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree', window );">Amortization expense for existing other intangible assets, 2021</a></td>
<td class="nump">53,771<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour', window );">Amortization expense for existing other intangible assets, 2022</a></td>
<td class="nump">46,249<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive', window );">Amortization expense for existing other intangible assets, 2023</a></td>
<td class="nump">$ 40,448<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of amortization expense for assets, excluding financial assets and goodwill, lacking physical substance with a finite life expected to be recognized during the next fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths</td>
</tr>
<tr>
<td style="padding-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_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of amortization expense for assets, excluding financial assets and goodwill, lacking physical substance with a finite life expected to be recognized during the fifth fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive</td>
</tr>
<tr>
<td style="padding-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_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of amortization expense for assets, excluding financial assets and goodwill, lacking physical substance with a finite life expected to be recognized during the fourth fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour</td>
</tr>
<tr>
<td style="padding-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_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of amortization expense for assets, excluding financial assets and goodwill, lacking physical substance with a finite life expected to be recognized during the third fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</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_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of amortization expense for assets, excluding financial assets and goodwill, lacking physical substance with a finite life expected to be recognized during the second fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=66006027&amp;loc=d3e16323-109275<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</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_GoodwillAndIntangibleAssetsDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_GoodwillAndIntangibleAssetsDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-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>69
<FILENAME>R52.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6811715440">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Accounts Payable and Accrued Expenses - Schedule of Accounts Payable and Accrued Expenses (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 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">$ 31,059<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">249,834<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">80,369<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">34,931<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">18,760<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">9,477<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">44,912<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">$ 469,342<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>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of the current portion of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OtherAccruedLiabilitiesCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of expenses incurred but not yet paid classified as other, due within one year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</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>70
<FILENAME>R53.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6814610624">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Accrued Professional Liabilities - Additional Information (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PayablesAndAccrualsAbstract', window );"><strong>Payables and Accruals [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyAccrualUndiscounted', window );">Total accrued professional liability</a></td>
<td class="nump">$ 243,991<span></span>
</td>
<td class="nump">$ 250,187<span></span>
</td>
<td class="nump">$ 202,052<span></span>
</td>
<td class="nump">$ 202,527<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SelfInsuranceReserveCurrent', window );">Accrued professional liability incurred but loss reserves not reported for claims</a></td>
<td class="nump">139,100<span></span>
</td>
<td class="nump">138,500<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_AccruedProfessionalLiability', window );">Accrued professional liability incurred and loss reserves reported for claims</a></td>
<td class="nump">104,900<span></span>
</td>
<td class="nump">111,700<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent', window );">Accrued professional liabilities</a></td>
<td class="nump">34,931<span></span>
</td>
<td class="nump">$ 37,912<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_InsuranceSettlementsReceivable', window );">Insurance receivables</a></td>
<td class="nump">$ 16,700<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_AccruedProfessionalLiability">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Accrued professional liability.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_AccruedProfessionalLiability</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_InsuranceSettlementsReceivable">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount due in settlement of a claim for reimbursement from an insurance company when the Company has suffered a loss covered under an insurance policy.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_InsuranceSettlementsReceivable</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyAccrualUndiscounted">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability) at the end of the accounting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_MalpracticeLossContingencyAccrualUndiscounted</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of the current portion of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PayablesAndAccrualsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PayablesAndAccrualsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SelfInsuranceReserveCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Carrying amount of accrued known and estimated losses incurred as of the balance sheet date for which no insurance coverage exists, and for which a claim has been made or is probable of being asserted, typically arising from workmen's compensation-type of incidents and personal injury to nonemployees from accidents on the entity's property that are expected to be paid within one year (or the normal operating cycle, if longer).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SelfInsuranceReserveCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>71
<FILENAME>R54.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6820344080">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accrued Professional Liabilities - Schedule of Accrued Professional Liability (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PayablesAndAccrualsAbstract', window );"><strong>Payables and Accruals [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyAccrualUndiscounted', window );">Balance at beginning of year</a></td>
<td class="nump">$ 250,187<span></span>
</td>
<td class="nump">$ 202,052<span></span>
</td>
<td class="nump">$ 202,527<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition', window );">Assumed liabilities through acquisition</a></td>
<td class="nump">1,276<span></span>
</td>
<td class="nump">20,716<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_ProvisionAdjustmentForLossesRelatedToCurrentYear', window );">Provision (adjustment) for losses related to Current year</a></td>
<td class="nump">34,483<span></span>
</td>
<td class="nump">41,291<span></span>
</td>
<td class="nump">38,129<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_ProvisionAdjustmentForLossesRelatedToPriorYear', window );">Provision (adjustment) for losses related to Prior years</a></td>
<td class="nump">10,299<span></span>
</td>
<td class="nump">9,983<span></span>
</td>
<td class="num">(25,428)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_MalpracticeLossContingencyProvisionForLosses', window );">Total provision for losses</a></td>
<td class="nump">44,782<span></span>
</td>
<td class="nump">51,274<span></span>
</td>
<td class="nump">12,701<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod', window );">Claim payments related to Current year</a></td>
<td class="num">(555)<span></span>
</td>
<td class="num">(712)<span></span>
</td>
<td class="num">(766)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods', window );">Claim payments related to Prior years</a></td>
<td class="num">(51,699)<span></span>
</td>
<td class="num">(23,143)<span></span>
</td>
<td class="num">(12,410)<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyClaimsIncurredNet', window );">Total payments</a></td>
<td class="num">(52,254)<span></span>
</td>
<td class="num">(23,855)<span></span>
</td>
<td class="num">(13,176)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_MalpracticeLossContingencyAccrualUndiscounted', window );">Balance at end of year</a></td>
<td class="nump">$ 243,991<span></span>
</td>
<td class="nump">$ 250,187<span></span>
</td>
<td class="nump">$ 202,052<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Accrued professional liabilities assumed through acquisition.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_AccruedProfessionalLiabilitiesAssumedThroughAcquisition</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_MalpracticeLossContingencyProvisionForLosses">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Malpractice loss contingency provision for losses.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_MalpracticeLossContingencyProvisionForLosses</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_ProvisionAdjustmentForLossesRelatedToCurrentYear">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Provision (adjustment) for losses related to current year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_ProvisionAdjustmentForLossesRelatedToCurrentYear</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_ProvisionAdjustmentForLossesRelatedToPriorYear">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Provision (adjustment) for losses related to prior year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_ProvisionAdjustmentForLossesRelatedToPriorYear</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyAccrualUndiscounted">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of the accrued liability on an undiscounted basis for malpractice claims (including general and professional liability) at the end of the accounting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_MalpracticeLossContingencyAccrualUndiscounted</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of loss recognized for asserted and unasserted malpractice claims.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 450<br> -Section 30<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=68049836&amp;loc=d3e5870-115623<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyClaimsIncurredInPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in asserted and unasserted malpractice claims that were originally recognized in a prior period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 450<br> -Section 30<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=68049836&amp;loc=d3e5870-115623<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyClaimsIncurredInPriorPeriods</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_MalpracticeLossContingencyClaimsIncurredNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of costs associated with malpractice claims and insurance premiums incurred during an accounting period, less insurance recoveries and returns of previously paid premiums.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 450<br> -Section 30<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=68049836&amp;loc=d3e5870-115623<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 720<br> -Section 25<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=68060100&amp;loc=d3e8578-115644<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_MalpracticeLossContingencyClaimsIncurredNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PayablesAndAccrualsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PayablesAndAccrualsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>72
<FILENAME>R55.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6833846720">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations - Additional Information (Detail) - USD ($)<br></strong></div></th>
<th class="th" colspan="1">12 Months Ended</th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1"></th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Nov. 30, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityExpirationDate1', window );">Line of Credit facility, maturity date</a></td>
<td class="text">Oct. 31,  2022<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebt', window );">Long term debt</a></td>
<td class="nump">$ 1,969,818,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 1,846,133,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LettersOfCreditOutstandingAmount', window );">Letters of credit outstanding amount</a></td>
<td class="nump">200,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity', window );">Line of Credit facility, available balance</a></td>
<td class="nump">$ 1,300,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</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_RangeAxis=srt_MinimumMember', window );">Minimum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityCommitmentFeePercentage', window );">Commitment fee percentage</a></td>
<td class="nump">0.15%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<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_srt_RangeAxis=srt_MaximumMember', window );">Maximum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityCommitmentFeePercentage', window );">Commitment fee percentage</a></td>
<td class="nump">0.30%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentAxis=md_AlternateBaseRateMember', window );">Alternate Base Rate [Member] | Federal Funds Rate [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<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_DebtInstrumentDescriptionOfVariableRateBasis', window );">Debt instrument, interest rate</a></td>
<td class="text">Federal Funds Rate plus 1/2 of 1.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentAxis=md_AlternateBaseRateMember', window );">Alternate Base Rate [Member] | LIBOR [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentDescriptionOfVariableRateBasis', window );">Debt instrument, interest rate</a></td>
<td class="text">LIBOR  for an interest period of one month plus 1.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentBasisSpreadOnVariableRate1', window );">Debt instrument, variable interest rate</a></td>
<td class="nump">1.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentAxis=md_ApplicableMarginRateMember', window );">Applicable Margin Rate [Member] | LIBOR [Member] | Minimum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentBasisSpreadOnVariableRate1', window );">Debt instrument, variable interest rate</a></td>
<td class="nump">0.125%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentAxis=md_ApplicableMarginRateMember', window );">Applicable Margin Rate [Member] | LIBOR [Member] | Maximum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentBasisSpreadOnVariableRate1', window );">Debt instrument, variable interest rate</a></td>
<td class="nump">0.75%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_UnsecuredRevolvingCreditFacilityMember', window );">Unsecured Revolving Credit Facility [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity', window );">Line of Credit facility, borrowing capacity</a></td>
<td class="nump">$ 2,000,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=us-gaap_LetterOfCreditMember', window );">Letters of Credit [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity', window );">Line of Credit facility, borrowing capacity</a></td>
<td class="nump">$ 37,500,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentFaceAmount', window );">Aggregate principal amount of debt</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 750,000,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentInterestRateStatedPercentage', window );">Debt instrument interest rate</a></td>
<td class="nump">5.25%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">5.25%<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentMaturityDateDescription', window );">Debt instrument maturity date description</a></td>
<td class="text">Payable semi-annually in arrears on June 1 and December 1<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_DebtInstrumentMaturityYear', window );">Debt instrument, maturity year</a></td>
<td class="text">2023<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebt', window );">Long term debt</a></td>
<td class="nump">$ 1,234,592,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 740,497,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member] | Change In Control [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">101.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member] | Redemption in 2019 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">102.625%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member] | Redemption in 2020 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">101.313%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member] | Redemption in 2021 and Thereafter [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">100.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="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_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember', window );">6.25% Senior Unsecured Notes Due 2027 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<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_DebtInstrumentFaceAmount', window );">Aggregate principal amount of debt</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 500,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentInterestRateStatedPercentage', window );">Debt instrument interest rate</a></td>
<td class="nump">6.25%<span></span>
</td>
<td class="nump">6.25%<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_DebtInstrumentMaturityDateDescription', window );">Debt instrument maturity date description</a></td>
<td class="text">Payable semi-annually in arrears on January 15 and July 15<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_DebtInstrumentMaturityYear', window );">Debt instrument, maturity year</a></td>
<td class="text">2027<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember', window );">6.25% Senior Unsecured Notes Due 2027 [Member] | Change In Control [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">101.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="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_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember', window );">6.25% Senior Unsecured Notes Due 2027 [Member] | Redemption Before 2022 [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_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">100.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="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_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember', window );">6.25% Senior Unsecured Notes Due 2027 [Member] | Redemption Before 2022 [Member] | Redeem up to 35% of Aggregate Principal Amount [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">35.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentage', window );">Redemption price percentage of aggregate principal amount redeemed</a></td>
<td class="nump">106.25%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember', window );">6.25% Senior Unsecured Notes Due 2027 [Member] | Redemption in 2022 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">104.688%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember', window );">6.25% Senior Unsecured Notes Due 2027 [Member] | Redemption in 2023 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">103.125%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember', window );">6.25% Senior Unsecured Notes Due 2027 [Member] | Redemption in 2024 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">101.563%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember', window );">6.25% Senior Unsecured Notes Due 2027 [Member] | Redemption in 2025 and Thereafter [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed', window );">Redemption percentage of principal amount</a></td>
<td class="nump">100.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_DebtInstrumentMaturityYear">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Debt instrument maturity year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_DebtInstrumentMaturityYear</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:gYearItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentBasisSpreadOnVariableRate1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage points added to the reference rate to compute the variable rate on the debt instrument.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentBasisSpreadOnVariableRate1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentDescriptionOfVariableRateBasis">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The reference rate for the variable rate of the debt instrument, such as LIBOR or the US Treasury rate and the maturity of the reference rate used, such as three months or six months LIBOR.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentDescriptionOfVariableRateBasis</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentFaceAmount">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Face (par) amount of debt instrument at time of issuance.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 2<br> -URI http://asc.fasb.org/extlink&amp;oid=114775744&amp;loc=d3e28551-108399<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 55<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=114775985&amp;loc=d3e28878-108400<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentFaceAmount</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentInterestRateStatedPercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Contractual interest rate for funds borrowed, under the debt agreement.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentMaturityDateDescription">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Description of the maturity date of the debt instrument including whether the debt matures serially and, if so, a brief description of the serial maturities.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(2))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentMaturityDateDescription</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentRedemptionPricePercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage price of original principal amount of debt at which debt can be redeemed by the issuer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 470<br> -Section 50<br> -Paragraph 3<br> -Subparagraph e<br> -URI http://asc.fasb.org/extlink&amp;oid=75038535&amp;loc=d3e64711-112823<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPricePercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of principal amount of debt redeemed.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPricePercentageOfPrincipalAmountRedeemed</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LettersOfCreditOutstandingAmount">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The total amount of the contingent obligation under letters of credit outstanding as of the reporting date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LettersOfCreditOutstandingAmount</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LineOfCreditFacilityCommitmentFeePercentage">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The fee, expressed as a percentage of the line of credit facility, for the line of credit facility regardless of whether the facility has been used.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LineOfCreditFacilityCommitmentFeePercentage</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LineOfCreditFacilityExpirationDate1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Date the credit facility terminates, in CCYY-MM-DD format.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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(b),22(b))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LineOfCreditFacilityExpirationDate1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:dateItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Maximum borrowing capacity under the credit facility without consideration of any current restrictions on the amount that could be borrowed or the amounts currently outstanding under the facility.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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(b),22(b))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of borrowing capacity currently available under the credit facility (current borrowing capacity less the amount of borrowings outstanding).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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(b),22(b))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LongTermDebt">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, after unamortized (discount) premium and debt issuance costs, of long-term debt. Includes, but not limited to, notes payable, bonds payable, debentures, mortgage loans and commercial paper. Excludes capital lease obligations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 470<br> -SubTopic 20<br> -Section 50<br> -Paragraph 4<br> -Subparagraph (b)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=109500613&amp;loc=SL6031897-161870<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)(16))<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(16))<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 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(22))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LongTermDebt</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_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>
</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>
</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_DebtInstrumentAxis=md_AlternateBaseRateMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentAxis=md_AlternateBaseRateMember</td>
</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_VariableRateAxis=us-gaap_FederalFundsEffectiveSwapRateMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_VariableRateAxis=us-gaap_FederalFundsEffectiveSwapRateMember</td>
</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_VariableRateAxis=us-gaap_LondonInterbankOfferedRateLIBORMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_VariableRateAxis=us-gaap_LondonInterbankOfferedRateLIBORMember</td>
</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_DebtInstrumentAxis=md_ApplicableMarginRateMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentAxis=md_ApplicableMarginRateMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_UnsecuredRevolvingCreditFacilityMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=md_UnsecuredRevolvingCreditFacilityMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=us-gaap_LetterOfCreditMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=us-gaap_LetterOfCreditMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OtherOwnershipInterestsByNameAxis=md_ChangeInControlMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OtherOwnershipInterestsByNameAxis=md_ChangeInControlMember</td>
</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_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodOneMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodOneMember</td>
</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_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodTwoMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodTwoMember</td>
</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_DebtInstrumentRedemptionPeriodAxis=md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=md_DebtInstrumentRedemptionPeriodThreeAndThereafterMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</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_DebtInstrumentRedemptionPeriodAxis=md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=md_DebtInstrumentRedemptionPeriodBeforeTwoThousandTwentyTwoMember</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_StatementScenarioAxis=md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StatementScenarioAxis=md_RedeemUpToThirtyFivePercentageOfAggregatePrincipalAmountMember</td>
</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_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodThreeMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodThreeMember</td>
</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_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodFourMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodFourMember</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_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodFiveMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=us-gaap_DebtInstrumentRedemptionPeriodFiveMember</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_DebtInstrumentRedemptionPeriodAxis=md_DebtInstrumentRedemptionPeriodSixAndThereafterMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentRedemptionPeriodAxis=md_DebtInstrumentRedemptionPeriodSixAndThereafterMember</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>73
<FILENAME>R56.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6833269056">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Long-Term Debt (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 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_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentCarryingAmount', window );">Debt instrument principal amount</a></td>
<td class="nump">$ 1,989,500<span></span>
</td>
<td class="nump">$ 1,860,500<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnamortizedDebtIssuanceExpense', window );">Unamortized debt issuance cost</a></td>
<td class="num">(19,682)<span></span>
</td>
<td class="num">(14,367)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebt', window );">Long term debt</a></td>
<td class="nump">1,969,818<span></span>
</td>
<td class="nump">1,846,133<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember', window );">5.25% Senior Unsecured Notes Due 2023 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentCarryingAmount', window );">Debt instrument principal amount</a></td>
<td class="nump">1,250,000<span></span>
</td>
<td class="nump">750,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnamortizedDebtIssuanceExpense', window );">Unamortized debt issuance cost</a></td>
<td class="num">(15,408)<span></span>
</td>
<td class="num">(9,503)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebt', window );">Long term debt</a></td>
<td class="nump">1,234,592<span></span>
</td>
<td class="nump">740,497<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CreditFacilityAxis=us-gaap_RevolvingCreditFacilityMember', window );">Revolving Credit Facility [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentLineItems', window );"><strong>Debt Instrument [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtInstrumentCarryingAmount', window );">Debt instrument principal amount</a></td>
<td class="nump">739,500<span></span>
</td>
<td class="nump">1,110,500<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnamortizedDebtIssuanceExpense', window );">Unamortized debt issuance cost</a></td>
<td class="num">(4,274)<span></span>
</td>
<td class="num">(4,864)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LongTermDebt', window );">Long term debt</a></td>
<td class="nump">$ 735,226<span></span>
</td>
<td class="nump">$ 1,105,636<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_DebtInstrumentCarryingAmount">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, before unamortized (discount) premium and debt issuance costs, of long-term debt. Includes, but is not limited to, notes payable, bonds payable, commercial loans, mortgage loans, convertible debt, subordinated debt and other types of debt.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 470<br> -SubTopic 20<br> -Section 50<br> -Paragraph 4<br> -Subparagraph (b)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=109500613&amp;loc=SL6031897-161870<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(16))<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(22))<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 942<br> -SubTopic 210<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-03(16))<br> -URI http://asc.fasb.org/extlink&amp;oid=6876686&amp;loc=d3e534808-122878<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentCarryingAmount</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtInstrumentLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtInstrumentLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LongTermDebt">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, after unamortized (discount) premium and debt issuance costs, of long-term debt. Includes, but not limited to, notes payable, bonds payable, debentures, mortgage loans and commercial paper. Excludes capital lease obligations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 470<br> -SubTopic 20<br> -Section 50<br> -Paragraph 4<br> -Subparagraph (b)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=109500613&amp;loc=SL6031897-161870<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)(16))<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(16))<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 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(22))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LongTermDebt</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnamortizedDebtIssuanceExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The remaining balance of debt issuance expenses that were capitalized and are being amortized against income over the lives of the respective bond issues. This does not include the amounts capitalized as part of the cost of the utility plant or asset.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_UnamortizedDebtIssuanceExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=md_FivePointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=us-gaap_RevolvingCreditFacilityMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CreditFacilityAxis=us-gaap_RevolvingCreditFacilityMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>74
<FILENAME>R57.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6639211344">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations - Summary of Estimated Fair Value of Notes (Detail) - Level 2 [Member] - Estimate of Fair Value Measurement [Member] - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 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_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_DebtInstrumentFairValueLineItems', window );"><strong>Debt Instrument Fair Value [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</a></td>
<td class="nump">$ 736,725<span></span>
</td>
<td class="nump">$ 763,125<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_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember', window );">6.25% Senior Unsecured Notes Due 2027 [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_md_DebtInstrumentFairValueLineItems', window );"><strong>Debt Instrument Fair Value [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_NotesPayableFairValueDisclosure', window );">Estimated fair value</a></td>
<td class="nump">$ 482,500<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_DebtInstrumentFairValueLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Debt Instrument Fair Value [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_DebtInstrumentFairValueLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_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>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FairValueByFairValueHierarchyLevelAxis=us-gaap_FairValueInputsLevel2Member">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_FairValueByFairValueHierarchyLevelAxis=us-gaap_FairValueInputsLevel2Member</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_FairValueByMeasurementBasisAxis=us-gaap_EstimateOfFairValueFairValueDisclosureMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_FairValueByMeasurementBasisAxis=us-gaap_EstimateOfFairValueFairValueDisclosureMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CreditFacilityAxis=md_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_SixPointTwoFivePercentSeniorUnsecuredNotesDueTwoThousandTwentySevenMember</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>75
<FILENAME>R58.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6690640256">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Capital Lease Obligations (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 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_DebtDisclosureAbstract', window );"><strong>Debt Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeaseObligations', window );">Capital lease obligations</a></td>
<td class="nump">$ 441<span></span>
</td>
<td class="nump">$ 1,826<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeaseObligationsCurrent', window );">Less: Current portion</a></td>
<td class="num">(253)<span></span>
</td>
<td class="num">(1,401)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeaseObligationsNoncurrent', window );">Long-term portion</a></td>
<td class="nump">$ 188<span></span>
</td>
<td class="nump">$ 425<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeaseObligations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount equal to the present value (the principal) at the beginning of the lease term of minimum lease payments during the lease term (excluding that portion of the payments representing executory costs such as insurance, maintenance, and taxes to be paid by the lessor, together with any profit thereon) net of payments or other amounts applied to the principal through the balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br><br>Reference 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)(16))<br> -URI http://asc.fasb.org/extlink&amp;oid=6879938&amp;loc=d3e572229-122910<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeaseObligations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeaseObligationsCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of capital lease obligation due within one year or the normal operating cycle, if longer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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))<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 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84164758&amp;loc=d3e45023-112735<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeaseObligationsCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeaseObligationsNoncurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount equal to the present value (the principal) at the beginning of the lease term of minimum lease payments during the lease term (excluding that portion of the payments representing executory costs such as insurance, maintenance, and taxes to be paid by the lessor, together with any profit thereon) net of payments or other amounts applied to the principal, through the balance sheet date and due to be paid more than one year (or one operating cycle, if longer) after the balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84164758&amp;loc=d3e45023-112735<br><br>Reference 3: http://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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeaseObligationsNoncurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>76
<FILENAME>R59.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6823143408">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Amounts Due Under Terms of Capital Lease Obligations (Detail)<br> $ in Thousands</strong></div></th>
<th class="th">
<div>Dec. 31, 2018 </div>
<div>USD ($)</div>
</th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DebtDisclosureAbstract', window );"><strong>Debt Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent', window );">2019</a></td>
<td class="nump">$ 253<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears', window );">2020</a></td>
<td class="nump">114<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears', window );">2021</a></td>
<td class="nump">$ 74<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of minimum lease payments for capital leases due in the next fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeasesFutureMinimumPaymentsDueCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of minimum lease payments for capital leases due in the third fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeasesFutureMinimumPaymentsDueInThreeYears</td>
</tr>
<tr>
<td style="padding-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_CapitalLeasesFutureMinimumPaymentsDueInTwoYears">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of minimum lease payments for capital leases due in the second fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 30<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84164817&amp;loc=d3e45280-112737<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CapitalLeasesFutureMinimumPaymentsDueInTwoYears</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DebtDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DebtDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>77
<FILENAME>R60.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6833658080">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes - Summary of Components of Income Tax Provision (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Sep. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Mar. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<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_CurrentFederalTaxExpenseBenefit', window );">Federal, Current</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 97,754<span></span>
</td>
<td class="nump">$ 130,053<span></span>
</td>
<td class="nump">$ 166,758<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredFederalIncomeTaxExpenseBenefit', window );">Federal, Deferred</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(20,176)<span></span>
</td>
<td class="num">(63,038)<span></span>
</td>
<td class="nump">15,596<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_FederalIncomeTaxExpenseBenefitContinuingOperations', window );">Federal income tax provision, Total</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">77,578<span></span>
</td>
<td class="nump">67,015<span></span>
</td>
<td class="nump">182,354<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CurrentStateAndLocalTaxExpenseBenefit', window );">State, Current</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">26,605<span></span>
</td>
<td class="nump">20,070<span></span>
</td>
<td class="nump">4,296<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit', window );">State, Deferred</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(3,973)<span></span>
</td>
<td class="nump">2,965<span></span>
</td>
<td class="nump">2,553<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_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations', window );">State income tax provision, Total</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">22,632<span></span>
</td>
<td class="nump">23,035<span></span>
</td>
<td class="nump">6,849<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_IncomeTaxExpenseBenefit', window );">Income tax provision, Total</a></td>
<td class="nump">$ 21,156<span></span>
</td>
<td class="nump">$ 24,873<span></span>
</td>
<td class="nump">$ 30,122<span></span>
</td>
<td class="nump">$ 24,059<span></span>
</td>
<td class="num">$ (27,761)<span></span>
</td>
<td class="nump">$ 42,119<span></span>
</td>
<td class="nump">$ 40,725<span></span>
</td>
<td class="nump">$ 34,967<span></span>
</td>
<td class="nump">$ 100,210<span></span>
</td>
<td class="nump">$ 90,050<span></span>
</td>
<td class="nump">$ 189,203<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_CurrentFederalTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 federal tax expense (benefit) pertaining to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CurrentFederalTaxExpenseBenefit</td>
</tr>
<tr>
<td style="padding-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_CurrentStateAndLocalTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 state and local tax expense (benefit) pertaining to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 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 S99<br> -Paragraph 1<br> -Subparagraph (SAB Topic 6.I.7)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CurrentStateAndLocalTaxExpenseBenefit</td>
</tr>
<tr>
<td style="padding-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_DeferredFederalIncomeTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 federal income tax expense (benefit) pertaining to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br><br>Reference 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 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB Topic 6.I.7)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredFederalIncomeTaxExpenseBenefit</td>
</tr>
<tr>
<td style="padding-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_DeferredStateAndLocalIncomeTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 state and local tax expense (benefit) pertaining to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_FederalIncomeTaxExpenseBenefitContinuingOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of current and deferred federal income tax expense (benefit) attributable to income (loss) from continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(1))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<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 50<br> -Paragraph 10<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32672-109319<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_FederalIncomeTaxExpenseBenefitContinuingOperations</td>
</tr>
<tr>
<td style="padding-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_IncomeTaxDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_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_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of state and local current and deferred income tax expense (benefit) attributable to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (a)-(b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br><br>Reference 2: http://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)(1))<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 740<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SAB TOPIC 6.I.7)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StateAndLocalIncomeTaxExpenseBenefitContinuingOperations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>78
<FILENAME>R61.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6835183072">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes - Additional Information (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="4">12 Months Ended</th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1"></th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Sep. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Mar. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2019</div></th>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Sep. 30, 2016</div></th>
<th class="th"><div>Dec. 31, 2015</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate', window );">Tax at statutory rate</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">21.00%<span></span>
</td>
<td class="nump">35.00%<span></span>
</td>
<td class="nump">35.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateContinuingOperations', window );">Effective tax rate</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">27.17%<span></span>
</td>
<td class="nump">21.94%<span></span>
</td>
<td class="nump">36.80%<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_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability', window );">Income tax benefit resulting from the reduction of deferred tax liabilities</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="num">$ (70,000)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate', window );">Effective income tax rate favorable impact of change in uncertain tax positions</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 10,600<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncreaseDecreaseInDeferredLiabilities', window );">Increase (decrease) in net deferred tax liability</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="num">$ (23,600)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</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_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts', window );">Increase in allowance for uncollectible accounts</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">114,800<span></span>
</td>
<td class="text">&#160;<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_DeferredTaxLiabilitiesChangeInAccountingMethod', window );">Accounting method changes</a></td>
<td class="nump">$ 109,418<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">4,150<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">109,418<span></span>
</td>
<td class="nump">$ 4,150<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_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals', window );">Decrease in accrual to cash adjustment</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">31,300<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet', window );">Adjustment to additional paid-in capital for excess tax benefits related to stock-based awards</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 4,200<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_IncomeTaxExpenseForExcessTaxDeficiencies', window );">Income tax expense for excess tax deficiencies</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1,400<span></span>
</td>
<td class="nump">200<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLossCarryforwards', window );">Net operating loss carryforwards for federal and state tax</a></td>
<td class="nump">101,900<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">116,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">101,900<span></span>
</td>
<td class="nump">116,000<span></span>
</td>
<td class="nump">130,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration', window );">Operating loss carryforwards subject to expiration</a></td>
<td class="nump">74,300<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">74,300<span></span>
</td>
<td class="text">&#160;<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_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration', window );">Operating loss carryforwards not subject to expiration</a></td>
<td class="nump">27,600<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">27,600<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefits', window );">Uncertain tax position liability</a></td>
<td class="nump">11,185<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">10,972<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">11,185<span></span>
</td>
<td class="nump">10,972<span></span>
</td>
<td class="nump">9,469<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 18,447<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate', window );">Unrecognized tax benefits that would impact effective tax rate</a></td>
<td class="nump">10,900<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">10,900<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease', window );">Increase (decrease) in uncertain tax position</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">200<span></span>
</td>
<td class="nump">1,500<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_IncomeTaxExpenseBenefit', window );">Income tax expense (benefit)</a></td>
<td class="nump">21,156<span></span>
</td>
<td class="nump">$ 24,873<span></span>
</td>
<td class="nump">$ 30,122<span></span>
</td>
<td class="nump">$ 24,059<span></span>
</td>
<td class="num">(27,761)<span></span>
</td>
<td class="nump">$ 42,119<span></span>
</td>
<td class="nump">$ 40,725<span></span>
</td>
<td class="nump">$ 34,967<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">100,210<span></span>
</td>
<td class="nump">90,050<span></span>
</td>
<td class="nump">189,203<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_IncomeTaxExaminationPenaltiesAndInterestAccrued', window );">Company's accrued liability for interest and penalties related to income tax liabilities</a></td>
<td class="nump">1,100<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 1,200<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 1,100<span></span>
</td>
<td class="nump">1,200<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis=md_InterestAndPenaltiesMember', window );">Interest and Penalties [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<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_IncomeTaxExpenseBenefit', window );">Income tax expense (benefit)</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 200<span></span>
</td>
<td class="nump">$ 7,900<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_TaxPeriodAxis=us-gaap_EarliestTaxYearMember', window );">Earliest Tax Year [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OpenTaxYear', window );">Federal and state income tax examinations</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">2014<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_TaxPeriodAxis=us-gaap_LatestTaxYearMember', window );">Latest Tax Year [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OpenTaxYear', window );">Federal and state income tax examinations</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">2017<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ChangeInAccountingEstimateByTypeAxis=md_InternalRevenueCodeSection481Member', window );">Internal Revenue Code Section 481 [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<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_DeferredTaxLiabilitiesChangeInAccountingMethod', window );">Accounting method changes</a></td>
<td class="nump">$ 105,300<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 105,300<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StatementScenarioAxis=us-gaap_ScenarioForecastMember', window );">Scenario, Forecast [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<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_UnrecognizedTaxBenefitsPeriodIncreaseDecrease', window );">Increase (decrease) in uncertain tax position</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 200<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="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_srt_RangeAxis=srt_MinimumMember', window );">Minimum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NetOperatingLossCarryForwardsExpirationDate', window );">Expiration period of operating loss carryforwards</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">2019<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<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_srt_RangeAxis=srt_MaximumMember', window );">Maximum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncomeTaxLineItems', window );"><strong>Income Tax [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_NetOperatingLossCarryForwardsExpirationDate', window );">Expiration period of operating loss carryforwards</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">2038<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_DeferredTaxLiabilitiesChangeInAccountingMethod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Deferred tax liabilities change in accounting method.</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_DeferredTaxLiabilitiesChangeInAccountingMethod</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_IncomeTaxExpenseForExcessTaxDeficiencies">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Income tax expense for excess tax deficiencies.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_IncomeTaxExpenseForExcessTaxDeficiencies</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_IncomeTaxLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Income Tax [Line Items]</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_IncomeTaxLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 deferred tax assets tax deferred expense reserves and accruals allowance for doubtful accounts.</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_IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts</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_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 deferred tax liabilities deferred expense reserves and accruals.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_NetOperatingLossCarryForwardsExpirationDate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Net operating loss carry forwards expiration date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_NetOperatingLossCarryForwardsExpirationDate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:gYearItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Unrecognized tax benefits impact effective tax rate.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_UnrecognizedTaxBenefitsImpactEffectiveTaxRate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) in additional paid in capital (APIC) resulting from a tax benefit (deficiency) associated with an share-based compensation plan other than an employee stock ownership plan (ESOP).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible operating loss carryforwards that are not subject to expiration dates.</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_DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration</td>
</tr>
<tr>
<td style="padding-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_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible operating loss carryforwards that are subject to expiration dates.</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_DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateContinuingOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(2))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<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 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<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 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateContinuingOperations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of domestic federal statutory tax rate applicable to pretax income (loss).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)<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 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of estimated penalties and interest accrued as of the balance sheet date arising from income tax examinations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32718-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxExpenseBenefit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/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_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of income tax expense (benefit) from continuing operations attributable to an adjustment of a deferred tax liability or asset for enacted changes in tax laws or rates or a change in the tax status of the entity.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 9<br> -Subparagraph (g)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32639-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncreaseDecreaseInDeferredLiabilities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Change during the period in carrying value for all deferred liabilities due within one year or operating cycle.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_IncreaseDecreaseInDeferredLiabilities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OpenTaxYear">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tax year that remains open to examination under enacted tax laws, in CCYY format.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15<br> -Subparagraph (e)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32718-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OpenTaxYear</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>us-types:gYearListItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLossCarryforwards">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of operating loss carryforward, before tax effects, available to reduce future taxable income under enacted tax laws.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 3<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32559-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLossCarryforwards</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnrecognizedTaxBenefits">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of unrecognized tax benefits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 45<br> -Paragraph 10B<br> -URI http://asc.fasb.org/extlink&amp;oid=84176650&amp;loc=SL37586934-109318<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 50<br> -Paragraph 15A<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefits</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase (decrease) in unrecognized tax benefits attributable to uncertain tax positions taken in tax returns.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsPeriodIncreaseDecrease</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The total amount of unrecognized tax benefits that, if recognized, would affect the effective tax rate.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis=md_InterestAndPenaltiesMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ReasonablyPossibleSignificantChangeInUnrecognizedTaxBenefitsByItemAxis=md_InterestAndPenaltiesMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_TaxPeriodAxis=us-gaap_EarliestTaxYearMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_TaxPeriodAxis=us-gaap_EarliestTaxYearMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_TaxPeriodAxis=us-gaap_LatestTaxYearMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_TaxPeriodAxis=us-gaap_LatestTaxYearMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ChangeInAccountingEstimateByTypeAxis=md_InternalRevenueCodeSection481Member">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_ChangeInAccountingEstimateByTypeAxis=md_InternalRevenueCodeSection481Member</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_StatementScenarioAxis=us-gaap_ScenarioForecastMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StatementScenarioAxis=us-gaap_ScenarioForecastMember</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_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>
</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>
</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>79
<FILENAME>R62.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6657913008">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes - Schedule of Differences Between Effective Rate and United States Federal Income Tax Statutory Rate (Detail)<br></strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate', window );">Tax at statutory rate</a></td>
<td class="nump">21.00%<span></span>
</td>
<td class="nump">35.00%<span></span>
</td>
<td class="nump">35.00%<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes', window );">State income tax, net of federal benefit</a></td>
<td class="nump">4.80%<span></span>
</td>
<td class="nump">3.33%<span></span>
</td>
<td class="nump">2.94%<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense', window );">Non-deductible expenses</a></td>
<td class="nump">0.44%<span></span>
</td>
<td class="nump">0.49%<span></span>
</td>
<td class="nump">0.43%<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments', window );">Change in accrual estimates relating to uncertain tax positions</a></td>
<td class="nump">0.05%<span></span>
</td>
<td class="nump">0.02%<span></span>
</td>
<td class="num">(2.11%)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance', window );">Change in valuation allowance</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">0.48%<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent', window );">Other, net</a></td>
<td class="nump">1.20%<span></span>
</td>
<td class="nump">0.16%<span></span>
</td>
<td class="nump">0.06%<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate', window );">Change in tax law</a></td>
<td class="num">(0.32%)<span></span>
</td>
<td class="num">(17.06%)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EffectiveIncomeTaxRateContinuingOperations', window );">Income tax provision</a></td>
<td class="nump">27.17%<span></span>
</td>
<td class="nump">21.94%<span></span>
</td>
<td class="nump">36.80%<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateContinuingOperations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(2))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e23780-122690<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 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<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 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateContinuingOperations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of domestic federal statutory tax rate applicable to pretax income (loss).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)<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 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to changes in the valuation allowance for deferred tax assets.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)<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 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance</td>
</tr>
<tr>
<td style="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_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to changes in the income tax rates.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)<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 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br><br>Reference 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 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to nondeductible expenses.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br><br>Reference 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 S99<br> -Paragraph 1<br> -Subparagraph (SAB TOPIC 6.I)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to other adjustments.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)<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 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br><br>Reference 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 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationOtherAdjustments</td>
</tr>
<tr>
<td style="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_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference, between reported income tax expense (benefit) and the expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations, that is attributable to tax exempt income, equity in earnings (loss) of an unconsolidated subsidiary, minority interest income (expense), tax holiday, disposition of a business, disposition of an asset, repatriation of foreign earnings, repatriation of foreign earnings jobs creation act of 2004, change in enacted tax rate, prior year income taxes, change in deferred tax asset valuation allowance, and other adjustments.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</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_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations applicable to state and local income tax expense (benefit), net of federal tax expense (benefit).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 13<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32698-109319<br><br>Reference 2: http://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)<br> -URI http://asc.fasb.org/extlink&amp;oid=34349781&amp;loc=d3e330036-122817<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 50<br> -Paragraph 12<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32687-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:percentItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>80
<FILENAME>R63.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6819760656">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Dec. 31, 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_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts', window );">Allowance for uncollectible accounts</a></td>
<td class="nump">$ 194,876<span></span>
</td>
<td class="nump">$ 80,056<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves', window );">Reserves and accruals</a></td>
<td class="nump">59,270<span></span>
</td>
<td class="nump">45,454<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_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost', window );">Stock-based compensation</a></td>
<td class="nump">9,201<span></span>
</td>
<td class="nump">7,975<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsOperatingLossCarryforwards', window );">Net operating loss carryforward</a></td>
<td class="nump">25,226<span></span>
</td>
<td class="nump">28,569<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment', window );">Property and equipment</a></td>
<td class="nump">26<span></span>
</td>
<td class="nump">685<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsOther', window );">Other</a></td>
<td class="nump">1,197<span></span>
</td>
<td class="nump">970<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsGross', window );">Deferred tax assets before valuation allowance</a></td>
<td class="nump">289,796<span></span>
</td>
<td class="nump">163,709<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsValuationAllowance', window );">Less: Valuation allowance</a></td>
<td class="num">(2,628)<span></span>
</td>
<td class="num">(2,615)<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxAssetsNet', window );">Deferred tax assets, net of valuation allowance</a></td>
<td class="nump">287,168<span></span>
</td>
<td class="nump">161,094<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxLiabilitiesAbstract', window );"><strong>Gross deferred tax liabilities:</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets', window );">Amortization</a></td>
<td class="num">(286,552)<span></span>
</td>
<td class="num">(258,618)<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_DeferredTaxLiabilitiesChangeInAccountingMethod', window );">Accounting method changes</a></td>
<td class="num">(109,418)<span></span>
</td>
<td class="num">(4,150)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals', window );">Accrual to cash adjustment</a></td>
<td class="num">(39)<span></span>
</td>
<td class="num">(31,290)<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_DeferredTaxLiabilitiesOther', window );">Other</a></td>
<td class="num">(489)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DeferredIncomeTaxLiabilities', window );">Total deferred tax liabilities</a></td>
<td class="num">(396,498)<span></span>
</td>
<td class="num">(294,058)<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_DeferredTaxLiabilities', window );">Net deferred tax liability</a></td>
<td class="num">$ (109,330)<span></span>
</td>
<td class="num">$ (132,964)<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_DeferredTaxLiabilitiesChangeInAccountingMethod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Deferred tax liabilities change in accounting method.</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_DeferredTaxLiabilitiesChangeInAccountingMethod</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_DeferredIncomeTaxLiabilities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred tax liability attributable to taxable temporary differences.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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(26)(b))<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(15)(b)(2))<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(15)(2))<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 210<br> -SubTopic 10<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.5-02(26)(a))<br> -URI http://asc.fasb.org/extlink&amp;oid=6877327&amp;loc=d3e13212-122682<br><br>Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredIncomeTaxLiabilities</td>
</tr>
<tr>
<td style="padding-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_DeferredTaxAssetsGross">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences and carryforwards.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsGross</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsNet">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount after allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences and carryforwards.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (b),(c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsOperatingLossCarryforwards">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible operating loss carryforwards.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=115928272&amp;loc=d3e28680-109314<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsOperatingLossCarryforwards</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsOther">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, before allocation of valuation allowance, of deferred tax asset attributable to deductible temporary differences, classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=115928272&amp;loc=d3e28680-109314<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 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<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 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsOther</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences from property, plant, and equipment.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsPropertyPlantAndEquipment</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences from share-based compensation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=115928272&amp;loc=d3e28680-109314<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 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<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 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount before allocation of valuation allowances of deferred tax asset attributable to deductible temporary differences from the allowance for doubtful accounts.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=115928272&amp;loc=d3e28680-109314<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, before allocation of valuation allowance, of deferred tax asset attributable to deductible temporary differences from reserves, classified as other.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -Subparagraph (b)<br> -URI http://asc.fasb.org/extlink&amp;oid=115928272&amp;loc=d3e28680-109314<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 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxAssetsValuationAllowance">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred tax assets for which it is more likely than not that a tax benefit will not be realized.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxAssetsValuationAllowance</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxLiabilities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount, after deferred tax asset, of deferred tax liability attributable to taxable differences without jurisdictional netting.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 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 50<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32537-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxLiabilities</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxLiabilitiesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxLiabilitiesAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred tax liability attributable to taxable temporary differences from reserves and accruals.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</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_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred tax liability attributable to taxable temporary differences from intangible assets other than goodwill.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=115928272&amp;loc=d3e28680-109314<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 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<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 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets</td>
</tr>
<tr>
<td style="padding-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_DeferredTaxLiabilitiesOther">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of deferred tax liability attributable to taxable temporary differences 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 740<br> -SubTopic 10<br> -Section 25<br> -Paragraph 20<br> -URI http://asc.fasb.org/extlink&amp;oid=115928272&amp;loc=d3e28680-109314<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 50<br> -Paragraph 8<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32632-109319<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 50<br> -Paragraph 6<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=d3e32621-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DeferredTaxLiabilitiesOther</td>
</tr>
<tr>
<td style="padding-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_IncomeTaxDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>81
<FILENAME>R64.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6770800432">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Income Taxes - Schedule of Activity Related to Gross Unrecognized Tax Benefits (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxDisclosureAbstract', window );"><strong>Income Tax Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<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_UnrecognizedTaxBenefits', window );">Balance at beginning of year</a></td>
<td class="nump">$ 10,972<span></span>
</td>
<td class="nump">$ 9,469<span></span>
</td>
<td class="nump">$ 18,447<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions', window );">Increases related to prior year tax positions</a></td>
<td class="nump">385<span></span>
</td>
<td class="nump">2,284<span></span>
</td>
<td class="nump">301<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions', window );">Decreases related to prior year tax positions</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(143)<span></span>
</td>
<td class="num">(3,927)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions', window );">Increases related to current year tax positions</a></td>
<td class="nump">2,900<span></span>
</td>
<td class="nump">1,430<span></span>
</td>
<td class="nump">2,258<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities', window );">Settlements</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="num">(5,644)<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations', window );">Decreases related to lapse of statutes of limitation</a></td>
<td class="num">(3,072)<span></span>
</td>
<td class="num">(2,068)<span></span>
</td>
<td class="num">(1,966)<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_UnrecognizedTaxBenefits', window );">Balance at end of year</a></td>
<td class="nump">$ 11,185<span></span>
</td>
<td class="nump">$ 10,972<span></span>
</td>
<td class="nump">$ 9,469<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_IncomeTaxDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_IncomeTaxDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnrecognizedTaxBenefits">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of unrecognized tax benefits.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 45<br> -Paragraph 10B<br> -URI http://asc.fasb.org/extlink&amp;oid=84176650&amp;loc=SL37586934-109318<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 50<br> -Paragraph 15A<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefits</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of decrease in unrecognized tax benefits resulting from tax positions taken in prior period tax returns.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions</td>
</tr>
<tr>
<td style="padding-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_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of decrease in unrecognized tax benefits resulting from settlements with taxing authorities.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)(3)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities</td>
</tr>
<tr>
<td style="padding-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_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in unrecognized tax benefits resulting from tax positions that have been or will be taken in current period tax return.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions</td>
</tr>
<tr>
<td style="padding-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_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in unrecognized tax benefits resulting from tax positions taken in prior period tax returns.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions</td>
</tr>
<tr>
<td style="padding-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_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of decrease in unrecognized tax benefits resulting from lapses of applicable statutes of limitations.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 10<br> -Section 50<br> -Paragraph 15A<br> -Subparagraph (a)(4)<br> -URI http://asc.fasb.org/extlink&amp;oid=84230637&amp;loc=SL6600010-109319<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>82
<FILENAME>R65.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6814616720">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common and Common Equivalent Shares - Schedule of Calculation of Shares Used in Basic and Diluted Net Income Per Share (Detail) - shares<br> shares in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Sep. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Mar. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EarningsPerShareAbstract', window );"><strong>Earnings Per Share [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_WeightedAverageNumberOfSharesOutstandingBasic', window );">Weighted average number of common shares outstanding</a></td>
<td class="nump">87,810<span></span>
</td>
<td class="nump">90,984<span></span>
</td>
<td class="nump">92,987<span></span>
</td>
<td class="nump">92,859<span></span>
</td>
<td class="nump">92,756<span></span>
</td>
<td class="nump">92,589<span></span>
</td>
<td class="nump">92,181<span></span>
</td>
<td class="nump">92,360<span></span>
</td>
<td class="nump">91,104<span></span>
</td>
<td class="nump">92,431<span></span>
</td>
<td class="nump">92,422<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements', window );">Weighted average number of dilutive common share equivalents</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">502<span></span>
</td>
<td class="nump">527<span></span>
</td>
<td class="nump">687<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">88,258<span></span>
</td>
<td class="nump">91,359<span></span>
</td>
<td class="nump">93,529<span></span>
</td>
<td class="nump">93,505<span></span>
</td>
<td class="nump">93,159<span></span>
</td>
<td class="nump">92,881<span></span>
</td>
<td class="nump">92,812<span></span>
</td>
<td class="nump">93,143<span></span>
</td>
<td class="nump">91,606<span></span>
</td>
<td class="nump">92,958<span></span>
</td>
<td class="nump">93,109<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount', window );">Antidilutive securities not included in the diluted net income per common share calculation</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">214<span></span>
</td>
<td class="nump">107<span></span>
</td>
<td class="nump">2<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>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>83
<FILENAME>R66.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6819545648">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Stock Incentive Plans and Stock Purchase Plans - Additional Information (Detail) - USD ($)<br></strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockSharesAuthorized', window );">Common stock, aggregate shares authorized</a></td>
<td class="nump">200,000,000<span></span>
</td>
<td class="nump">200,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AllocatedShareBasedCompensationExpense', window );">Stock-based compensation expense</a></td>
<td class="nump">$ 38,700,000<span></span>
</td>
<td class="nump">$ 29,600,000<span></span>
</td>
<td class="nump">$ 34,000,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue', window );">Aggregate fair value of restricted and deferred stocks vested</a></td>
<td class="nump">$ 27,400,000<span></span>
</td>
<td class="nump">$ 29,300,000<span></span>
</td>
<td class="nump">$ 29,800,000<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue', window );">Weighted average grant-date fair value of restricted and deferred stock awards granted</a></td>
<td class="nump">$ 51.99<span></span>
</td>
<td class="nump">$ 54.22<span></span>
</td>
<td class="nump">$ 67.90<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue', window );">Aggregate intrinsic value of stock options exercised</a></td>
<td class="nump">$ 2,800,000<span></span>
</td>
<td class="nump">$ 5,500,000<span></span>
</td>
<td class="nump">$ 6,800,000<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation', window );">Excess tax benefit related to employee stock incentive plans</a></td>
<td class="nump">0<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">4,131,000<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation', window );">Cash proceeds received from the exercise of stock options</a></td>
<td class="nump">$ 3,700,000<span></span>
</td>
<td class="nump">$ 4,800,000<span></span>
</td>
<td class="nump">$ 4,700,000<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AwardTypeAxis=us-gaap_EmployeeStockOptionMember', window );">Stock Option [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1', window );">Award vesting period</a></td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AwardTypeAxis=us-gaap_EmployeeStockOptionMember', window );">Stock Option [Member] | Maximum [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod', window );">Vesting period of options, maximum years</a></td>
<td class="text">10 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember', window );">Restricted Stock [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1', window );">Award vesting period</a></td>
<td class="text">3 years<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AwardTypeAxis=md_RestrictedAndDeferredStockUnitsMember', window );">Restricted and Deferred Stock Units [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1', window );">Unrecognized compensation expense related to non-vested restricted stock, weighted-average period in years</a></td>
<td class="text">1 year 4 months 24 days<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions', window );">Unrecognized compensation expense related to non-vested restricted shares</a></td>
<td class="nump">$ 30,800,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PlanNameAxis=md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember', window );">1996 Non-Qualified Employee Stock Purchase Plan [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent', window );">Percentage of market value of common stock at which employees are permitted to purchase</a></td>
<td class="nump">85.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PlanNameAxis=md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember', window );">2015 Non-Qualified Stock Purchase Plan [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent', window );">Percentage of market value of common stock at which employees are permitted to purchase</a></td>
<td class="nump">90.00%<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PlanNameAxis=md_AmendedAndRestatedTwoThousandEightPlanMember', window );">Amended and Restated 2008 Plan [Member] | Stock Option [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant', window );">Shares available for future grants and awards under Stock Incentive Plans</a></td>
<td class="nump">2,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PlanNameAxis=md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember', window );">1996 Non-Qualified Employee Stock Purchase Plan and 2015 Non-Qualified Stock Purchase Plan [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems', window );"><strong>Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommonStockSharesAuthorized', window );">Common stock, aggregate shares authorized</a></td>
<td class="nump">2,600,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans', window );">Aggregate number Shares issued under Stock Purchase Plans</a></td>
<td class="nump">400,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<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">1,600,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of increase in additional paid in capital (APIC) resulting from a tax benefit associated with share-based compensation plan other than an employee stock ownership plan (ESOP). Includes, but is not limited to, excess tax benefit.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 718<br> -SubTopic 740<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=109245112&amp;loc=d3e23524-113945<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AllocatedShareBasedCompensationExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Represents the expense recognized during the period arising from equity-based compensation arrangements (for example, shares of stock, unit, stock options or other equity instruments) with employees, directors and certain consultants qualifying for treatment as employees.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average period over which unrecognized compensation is expected to be recognized for equity-based compensation plans, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 (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_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Unrecognized cost of unvested share-based awards, other than options, awarded to employees as compensation.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 (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_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedShareBasedAwardsOtherThanOptions</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate cash inflow comprised of the amount received from (a) employees to acquire the entity's shares under incentive awards, including stock option exercises and restricted stock arrangements, and (b) the excess tax benefit arising from such transactions.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ProceedsAndExcessTaxBenefitFromSharebasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Period which an employee's right to exercise an award is no longer contingent on satisfaction of either a service condition, market condition or a performance condition, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:durationItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The weighted average fair value at grant date for nonvested equity-based awards issued during the period on other than stock (or unit) option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, performance target plan).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Fair value of share-based awards for which the grantee gained the right by satisfying service and performance requirements, to receive or retain shares or units, other instruments, or cash.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 (d)(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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The difference between the maximum number of shares (or other type of equity) authorized for issuance under the plan (including the effects of amendments and adjustments), and the sum of: 1) the number of shares (or other type of equity) already issued upon exercise of options or other equity-based awards under the plan; and 2) shares (or other type of equity) reserved for issuance on granting of outstanding awards, net of cancellations and forfeitures, if applicable.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of accumulated difference between fair value of underlying shares on dates of exercise and exercise price on options exercised (or share units converted) into shares.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 (d)(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_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Period from grant date that an equity-based award expires, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
<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>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AwardTypeAxis=md_RestrictedAndDeferredStockUnitsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AwardTypeAxis=md_RestrictedAndDeferredStockUnitsMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<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_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>
</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_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>
</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_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>
</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_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>
</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>84
<FILENAME>R67.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6812815728">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Stock Incentive Plans and Stock Purchase Plans - Schedule of Restricted Stock and Deferred Stock Awards (Detail) - $ / shares<br></strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract', window );"><strong>Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber', window );">Number of Shares, Non-vested shares at January 1, 2018</a></td>
<td class="nump">1,041,034<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod', window );">Number of Shares, Awarded</a></td>
<td class="nump">770,480<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod', window );">Number of Shares, Forfeited</a></td>
<td class="num">(69,293)<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod', window );">Number of Shares, Vested</a></td>
<td class="num">(431,368)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber', window );">Number of Shares, Non-vested shares at December 31, 2018</a></td>
<td class="nump">1,310,853<span></span>
</td>
<td class="nump">1,041,034<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue', window );">Weighted Average Fair Value, Non-vested shares at January 1, 2018</a></td>
<td class="nump">$ 60.21<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue', window );">Weighted Average Fair Value, Awarded</a></td>
<td class="nump">51.99<span></span>
</td>
<td class="nump">$ 54.22<span></span>
</td>
<td class="nump">$ 67.90<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue', window );">Weighted Average Fair Value, Forfeited</a></td>
<td class="nump">56.65<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue', window );">Weighted Average Fair Value, Vested</a></td>
<td class="nump">63.57<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue', window );">Weighted Average Fair Value, Non-vested shares at December 31, 2018</a></td>
<td class="nump">$ 54.46<span></span>
</td>
<td class="nump">$ 60.21<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The number of equity-based payment instruments, excluding stock (or unit) options, that were forfeited during the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(1)(iv)(3)<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average fair value as of the grant date of equity-based award plans other than stock (unit) option plans that were not exercised or put into effect as a result of the occurrence of a terminating event.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(3)<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</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_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>
</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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The weighted average fair value at grant date for nonvested equity-based awards issued during the period on other than stock (or unit) option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, performance target plan).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The number of non-vested equity-based payment instruments, excluding stock (or unit) options, that validly exist and are outstanding as of the balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(i)-(ii)<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber</td>
</tr>
<tr>
<td style="padding-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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The weighted average fair value of nonvested awards on equity-based plans excluding option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, revenue or profit achievement stock award plan) for which the employer is contingently obligated to issue equity instruments or transfer assets to an employee who has not yet satisfied service or performance criteria necessary to gain title to proceeds from the sale of the award or underlying shares or units.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(i)-(ii)<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The number of equity-based payment instruments, excluding stock (or unit) options, that vested during the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The weighted average fair value as of grant date pertaining to an equity-based award plan other than a stock (or unit) option plan for which the grantee gained the right during the reporting period, by satisfying service and performance requirements, to receive or retain shares or units, other instruments, or cash in accordance with the terms of the arrangement.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>85
<FILENAME>R68.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6822088928">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Stock Incentive Plans and Stock Purchase Plans - Schedule of Activity and Certain Other Information Related to Stock Option Awards (Detail) - USD ($)<br> $ / shares in Units, $ in Millions</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract', window );"><strong>Disclosure of Compensation Related Costs, Share-based Payments [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber', window );">Number of Shares, Outstanding at January 1, 2018</a></td>
<td class="nump">246,342<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised', window );">Number of Shares, Exercised</a></td>
<td class="num">(133,366)<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber', window );">Number of Shares, Outstanding at December 31, 2018</a></td>
<td class="nump">112,976<span></span>
</td>
<td class="nump">246,342<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber', window );">Number of Shares, Exercisable at December 31, 2017</a></td>
<td class="nump">112,976<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice', window );">Weighted Average Exercise Price, Outstanding at January 1, 2018</a></td>
<td class="nump">$ 27.51<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice', window );">Weighted Average Exercise Price, Exercised</a></td>
<td class="nump">27.38<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice', window );">Weighted Average Exercise Price, Outstanding at December 31, 2018</a></td>
<td class="nump">27.65<span></span>
</td>
<td class="nump">$ 27.51<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice', window );">Weighted Average Exercise Price, Exercisable at December 31, 2018</a></td>
<td class="nump">$ 27.65<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2', window );">Weighted Average Remaining Contractual Term (in years), Outstanding at December 31, 2018</a></td>
<td class="text">1 year 3 months 18 days<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1', window );">Weighted Average Remaining Contractual Term (in years), Exercisable at December 31, 2018</a></td>
<td class="text">1 year 3 months 18 days<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue', window );">Aggregate Intrinsic Value, Exercised</a></td>
<td class="nump">$ 2.8<span></span>
</td>
<td class="nump">$ 5.5<span></span>
</td>
<td class="nump">$ 6.8<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue', window );">Aggregate Intrinsic Value, Outstanding at December 31, 2018</a></td>
<td class="nump">0.7<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1', window );">Aggregate Intrinsic Value, Exercisable at December 31, 2018</a></td>
<td class="nump">$ 0.7<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The number of shares into which fully or partially vested stock options outstanding as of the balance sheet date can be currently converted under the option plan.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(1)(iii)<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The weighted-average price as of the balance sheet date at which grantees can acquire the shares reserved for issuance on vested portions of options outstanding and currently exercisable under the stock option plan.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(1)(iii)<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of accumulated difference between fair value of underlying shares on dates of exercise and exercise price on options exercised (or share units converted) into shares.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 (d)(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_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount by which the current fair value of the underlying stock exceeds the exercise price of options outstanding.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of options outstanding, including both vested and non-vested options.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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><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 50<br> -Paragraph 2<br> -Subparagraph (c)(1)(i)-(ii)<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber</td>
</tr>
<tr>
<td style="padding-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_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average price at which grantees can acquire the shares reserved for issuance under the stock option plan.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(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_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>num:perShareItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average price at which option holders acquired shares when converting their stock options into shares.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</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_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of difference between fair value of the underlying shares reserved for issuance and exercise price of vested portions of options outstanding and currently exercisable.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1</td>
</tr>
<tr>
<td style="padding-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_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average remaining contractual term for vested portions of options outstanding and currently exercisable or convertible, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1</td>
</tr>
<tr>
<td style="padding-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_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Weighted average remaining contractual term for option awards outstanding, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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 (e)(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_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2</td>
</tr>
<tr>
<td style="padding-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_StockIssuedDuringPeriodSharesStockOptionsExercised">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of share options (or share units) exercised during the current period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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)(1)(iv)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=109197908&amp;loc=d3e5070-113901<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><br>Reference 5: 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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised</td>
</tr>
<tr>
<td style="padding-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>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>86
<FILENAME>R69.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6811863696">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common Stock Repurchase Programs - Additional Information (Detail) - USD ($)<br></strong></div></th>
<th class="th" colspan="1"></th>
<th class="th" colspan="1">1 Months Ended</th>
<th class="th" colspan="1">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
<th class="th" colspan="1"></th>
</tr>
<tr>
<th class="th"><div>Sep. 04, 2018</div></th>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
<th class="th"><div>Aug. 31, 2018</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockLineItems', window );"><strong>Common Stock [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchaseProgramAuthorizedAmount1', window );">Common stock authorized for repurchase</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 500,000,000<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_StockRepurchasedDuringPeriodValue', window );">Common stock repurchased</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 302,160,000<span></span>
</td>
<td class="nump">$ 70,192,000<span></span>
</td>
<td class="nump">$ 61,828,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StatementEquityComponentsAxis=us-gaap_CommonStockMember', window );">Common Stock [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockLineItems', window );"><strong>Common Stock [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodValue', window );">Common stock repurchased</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 70,000<span></span>
</td>
<td class="nump">$ 10,000<span></span>
</td>
<td class="nump">$ 9,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodShares', window );">Repurchased common stock, shares</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">7,041,000<span></span>
</td>
<td class="nump">1,038,000<span></span>
</td>
<td class="nump">946,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember', window );">Restricted Stock [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockLineItems', window );"><strong>Common Stock [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation', window );">Number of shares withheld to satisfy minimum statutory tax withholding obligations</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">54,909<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">38,257<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation', window );">Amount withheld to satisfy minimum statutory tax withholding obligations</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 2,500,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 2,100,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="rh">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_ShareRepurchaseProgramAxis=md_AcceleratedShareRepurchaseAgreementsMember', window );">Accelerated Share Repurchase (ASR) Agreements [Member]</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockLineItems', window );"><strong>Common Stock [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt', window );">Common stock purchase</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">$ 250,000,000<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_StockRepurchasedDuringPeriodValue', window );">Common stock repurchased</a></td>
<td class="nump">$ 250,000,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockRepurchasedDuringPeriodShares', window );">Repurchased common stock, shares</a></td>
<td class="nump">4,200,000<span></span>
</td>
<td class="nump">1,700,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_CommonStockLineItems">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Common Stock [Line Items]</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">md_CommonStockLineItems</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>md_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cash receipt from (payment to) bank; or stock received from (issuance to) bank in the settlement of the accelerated share repurchase agreement.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 505<br> -SubTopic 30<br> -Section 25<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=6405686&amp;loc=d3e22802-112653<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AcceleratedShareRepurchasesSettlementPaymentOrReceipt</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of adjustment to stockholders' equity associated with an employee's income tax withholding obligation as part of a net-share settlement of a share-based award.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>For net-share settlement of share-based awards when the employer settles employees' income tax withholding obligations, this element represents the number of shares the employees use to repay the employer.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:sharesItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockRepurchaseProgramAuthorizedAmount1">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of stock repurchase plan authorized.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StockRepurchaseProgramAuthorizedAmount1</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StockRepurchasedDuringPeriodShares">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Number of shares that have been repurchased during the period and have not been retired and are not held in treasury. Some state laws may govern the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_StatementEquityComponentsAxis=us-gaap_CommonStockMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_StatementEquityComponentsAxis=us-gaap_CommonStockMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_AwardTypeAxis=us-gaap_RestrictedStockMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_ShareRepurchaseProgramAxis=md_AcceleratedShareRepurchaseAgreementsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Details</a><div><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_ShareRepurchaseProgramAxis=md_AcceleratedShareRepurchaseAgreementsMember</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td></td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>87
<FILENAME>R70.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6832058352">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Retirement Plans - Additional Information (Detail) - USD ($)<br> $ in Millions</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CompensationAndRetirementDisclosureAbstract', window );"><strong>Retirement Benefits [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DefinedContributionPlanCostRecognized', window );">Expense of retirement plans related to the 401(k) Plans</a></td>
<td class="nump">$ 55.8<span></span>
</td>
<td class="nump">$ 50.7<span></span>
</td>
<td class="nump">$ 45.2<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CompensationAndRetirementDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CompensationAndRetirementDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_DefinedContributionPlanCostRecognized">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of cost for defined contribution plan.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 715<br> -SubTopic 70<br> -Section 50<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=49170846&amp;loc=d3e28014-114942<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_DefinedContributionPlanCostRecognized</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>88
<FILENAME>R71.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6812215296">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Commitments and Contingencies - Additional Information (Detail) - USD ($)<br> $ in Millions</strong></div></th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommitmentsAndContingenciesDisclosureAbstract', window );"><strong>Commitments and Contingencies Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LeaseAndRentalExpense', window );">Rent expense</a></td>
<td class="nump">$ 42.9<span></span>
</td>
<td class="nump">$ 42.6<span></span>
</td>
<td class="nump">$ 38.0<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommitmentsAndContingenciesDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommitmentsAndContingenciesDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_LeaseAndRentalExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of rent expense incurred for leased assets, including but not limited to, furniture and equipment, that is not directly or indirectly associated with the manufacture, sale or creation of a product or product line.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_LeaseAndRentalExpense</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>89
<FILENAME>R72.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6834885504">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Commitments and Contingencies - Schedule of Future Minimum Lease Payments under Non-Cancelable Operating Leases (Detail)<br> $ in Thousands</strong></div></th>
<th class="th">
<div>Dec. 31, 2018 </div>
<div>USD ($)</div>
</th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_CommitmentsAndContingenciesDisclosureAbstract', window );"><strong>Commitments and Contingencies Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent', window );">2019</a></td>
<td class="nump">$ 30,824<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_OperatingLeasesFutureMinimumPaymentsDueInTwoYears', window );">2020</a></td>
<td class="nump">22,038<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears', window );">2021</a></td>
<td class="nump">17,946<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears', window );">2022</a></td>
<td class="nump">12,708<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears', window );">2023</a></td>
<td class="nump">9,440<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter', window );">Thereafter</a></td>
<td class="nump">10,522<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDue', window );">Total</a></td>
<td class="nump">$ 103,478<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommitmentsAndContingenciesDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- References</a><div><p>No definition available.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_CommitmentsAndContingenciesDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:stringItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>na</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for leases having an initial or remaining non-cancelable letter-terms in excess of one year.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDue</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due in the next fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due in the fifth fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due in the fourth fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due in the third fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due in the second fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of required minimum rental payments for operating leases having an initial or remaining non-cancelable lease term in excess of one year due after the fifth fiscal year following the latest fiscal year. Excludes interim and annual periods when interim periods are reported on a rolling approach, from latest balance sheet date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 20<br> -Section 50<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=77902758&amp;loc=d3e41502-112717<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 840<br> -SubTopic 10<br> -Section 55<br> -Paragraph 40<br> -Subparagraph (Note 3)<br> -URI http://asc.fasb.org/extlink&amp;oid=82846649&amp;loc=d3e38371-112697<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>instant</td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>90
<FILENAME>R73.htm
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="report.css">
<script type="text/javascript" src="Show.js">/* Do Not Remove This Comment */</script><script type="text/javascript">
							function toggleNextSibling (e) {
							if (e.nextSibling.style.display=='none') {
							e.nextSibling.style.display='block';
							} else { e.nextSibling.style.display='none'; }
							}</script>
</head>
<body>
<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6821472944">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Selected Quarterly Financial Information - Summary of Company's Selected Quarterly Financial Information (Detail) - USD ($)<br> $ / shares in Units, shares in Thousands, $ in Thousands</strong></div></th>
<th class="th" colspan="8">3 Months Ended</th>
<th class="th" colspan="3">12 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Sep. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Mar. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Sep. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Mar. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</div></th>
<th class="th"><div>Dec. 31, 2016</div></th>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_QuarterlyFinancialInformationDisclosureAbstract', window );"><strong>Quarterly Financial Information Disclosure [Abstract]</strong></a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax', window );">Net revenue</a></td>
<td class="nump">$ 932,696<span></span>
</td>
<td class="nump">$ 896,652<span></span>
</td>
<td class="nump">$ 915,918<span></span>
</td>
<td class="nump">$ 901,857<span></span>
</td>
<td class="nump">$ 910,820<span></span>
</td>
<td class="nump">$ 868,951<span></span>
</td>
<td class="nump">$ 842,944<span></span>
</td>
<td class="nump">$ 835,597<span></span>
</td>
<td class="nump">$ 3,647,123<span></span>
</td>
<td class="nump">$ 3,458,312<span></span>
</td>
<td class="nump">$ 3,183,159<span></span>
</td>
</tr>
<tr class="re">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_PracticeSalariesAndBenefits', window );">Practice salaries and benefits</a></td>
<td class="nump">657,061<span></span>
</td>
<td class="nump">625,717<span></span>
</td>
<td class="nump">620,980<span></span>
</td>
<td class="nump">631,830<span></span>
</td>
<td class="nump">617,455<span></span>
</td>
<td class="nump">586,476<span></span>
</td>
<td class="nump">561,418<span></span>
</td>
<td class="nump">572,385<span></span>
</td>
<td class="nump">2,535,588<span></span>
</td>
<td class="nump">2,337,734<span></span>
</td>
<td class="nump">2,031,220<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_PracticeSuppliesAndOtherOperatingExpenses', window );">Practice supplies and other operating expenses</a></td>
<td class="nump">29,381<span></span>
</td>
<td class="nump">30,159<span></span>
</td>
<td class="nump">31,833<span></span>
</td>
<td class="nump">30,655<span></span>
</td>
<td class="nump">32,353<span></span>
</td>
<td class="nump">29,497<span></span>
</td>
<td class="nump">30,872<span></span>
</td>
<td class="nump">27,796<span></span>
</td>
<td class="nump">122,028<span></span>
</td>
<td class="nump">120,518<span></span>
</td>
<td class="nump">118,416<span></span>
</td>
</tr>
<tr class="re">
<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">112,789<span></span>
</td>
<td class="nump">102,905<span></span>
</td>
<td class="nump">107,908<span></span>
</td>
<td class="nump">108,776<span></span>
</td>
<td class="nump">108,895<span></span>
</td>
<td class="nump">101,430<span></span>
</td>
<td class="nump">103,015<span></span>
</td>
<td class="nump">103,765<span></span>
</td>
<td class="nump">432,378<span></span>
</td>
<td class="nump">417,105<span></span>
</td>
<td class="nump">372,572<span></span>
</td>
</tr>
<tr class="ro">
<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">29,891<span></span>
</td>
<td class="nump">28,709<span></span>
</td>
<td class="nump">26,518<span></span>
</td>
<td class="nump">26,163<span></span>
</td>
<td class="nump">26,414<span></span>
</td>
<td class="nump">25,116<span></span>
</td>
<td class="nump">25,735<span></span>
</td>
<td class="nump">25,614<span></span>
</td>
<td class="nump">111,281<span></span>
</td>
<td class="nump">102,879<span></span>
</td>
<td class="nump">89,264<span></span>
</td>
</tr>
<tr class="re">
<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">829,122<span></span>
</td>
<td class="nump">787,490<span></span>
</td>
<td class="nump">787,239<span></span>
</td>
<td class="nump">797,424<span></span>
</td>
<td class="nump">785,117<span></span>
</td>
<td class="nump">742,519<span></span>
</td>
<td class="nump">721,040<span></span>
</td>
<td class="nump">729,560<span></span>
</td>
<td class="nump">3,201,275<span></span>
</td>
<td class="nump">2,978,236<span></span>
</td>
<td class="nump">2,611,472<span></span>
</td>
</tr>
<tr class="ro">
<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">103,574<span></span>
</td>
<td class="nump">109,162<span></span>
</td>
<td class="nump">128,679<span></span>
</td>
<td class="nump">104,433<span></span>
</td>
<td class="nump">125,703<span></span>
</td>
<td class="nump">126,432<span></span>
</td>
<td class="nump">121,904<span></span>
</td>
<td class="nump">106,037<span></span>
</td>
<td class="nump">445,848<span></span>
</td>
<td class="nump">480,076<span></span>
</td>
<td class="nump">571,687<span></span>
</td>
</tr>
<tr class="re">
<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">967<span></span>
</td>
<td class="nump">1,302<span></span>
</td>
<td class="nump">1,202<span></span>
</td>
<td class="nump">1,464<span></span>
</td>
<td class="nump">2,777<span></span>
</td>
<td class="nump">235<span></span>
</td>
<td class="nump">365<span></span>
</td>
<td class="nump">576<span></span>
</td>
<td class="nump">4,935<span></span>
</td>
<td class="nump">3,953<span></span>
</td>
<td class="nump">2,019<span></span>
</td>
</tr>
<tr class="ro">
<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">(25,448)<span></span>
</td>
<td class="num">(21,782)<span></span>
</td>
<td class="num">(21,604)<span></span>
</td>
<td class="num">(19,935)<span></span>
</td>
<td class="num">(19,844)<span></span>
</td>
<td class="num">(18,428)<span></span>
</td>
<td class="num">(18,535)<span></span>
</td>
<td class="num">(17,752)<span></span>
</td>
<td class="num">(88,769)<span></span>
</td>
<td class="num">(74,559)<span></span>
</td>
<td class="num">(63,092)<span></span>
</td>
</tr>
<tr class="re">
<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 (loss) in earnings of unconsolidated affiliate</a></td>
<td class="nump">2,277<span></span>
</td>
<td class="nump">1,766<span></span>
</td>
<td class="nump">1,257<span></span>
</td>
<td class="nump">1,525<span></span>
</td>
<td class="num">(294)<span></span>
</td>
<td class="num">(240)<span></span>
</td>
<td class="nump">689<span></span>
</td>
<td class="nump">797<span></span>
</td>
<td class="nump">6,825<span></span>
</td>
<td class="nump">952<span></span>
</td>
<td class="nump">3,185<span></span>
</td>
</tr>
<tr class="ro">
<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">(22,204)<span></span>
</td>
<td class="num">(18,714)<span></span>
</td>
<td class="num">(19,145)<span></span>
</td>
<td class="num">(16,946)<span></span>
</td>
<td class="num">(17,361)<span></span>
</td>
<td class="num">(18,433)<span></span>
</td>
<td class="num">(17,481)<span></span>
</td>
<td class="num">(16,379)<span></span>
</td>
<td class="num">(77,009)<span></span>
</td>
<td class="num">(69,654)<span></span>
</td>
<td class="num">(57,888)<span></span>
</td>
</tr>
<tr class="re">
<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">81,370<span></span>
</td>
<td class="nump">90,448<span></span>
</td>
<td class="nump">109,534<span></span>
</td>
<td class="nump">87,487<span></span>
</td>
<td class="nump">108,342<span></span>
</td>
<td class="nump">107,999<span></span>
</td>
<td class="nump">104,423<span></span>
</td>
<td class="nump">89,658<span></span>
</td>
<td class="nump">368,839<span></span>
</td>
<td class="nump">410,422<span></span>
</td>
<td class="nump">513,799<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_IncomeTaxExpenseBenefit', window );">Income tax (provision) benefit</a></td>
<td class="num">(21,156)<span></span>
</td>
<td class="num">(24,873)<span></span>
</td>
<td class="num">(30,122)<span></span>
</td>
<td class="num">(24,059)<span></span>
</td>
<td class="nump">27,761<span></span>
</td>
<td class="num">(42,119)<span></span>
</td>
<td class="num">(40,725)<span></span>
</td>
<td class="num">(34,967)<span></span>
</td>
<td class="num">(100,210)<span></span>
</td>
<td class="num">(90,050)<span></span>
</td>
<td class="num">(189,203)<span></span>
</td>
</tr>
<tr class="re">
<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">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">268,629<span></span>
</td>
<td class="nump">320,372<span></span>
</td>
<td class="nump">324,596<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest', window );">Net loss attributable to noncontrolling interests</a></td>
<td class="nump">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="nump">0<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">318<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_NetIncomeLoss', window );">Net income attributable to MEDNAX, Inc.</a></td>
<td class="nump">$ 60,214<span></span>
</td>
<td class="nump">$ 65,575<span></span>
</td>
<td class="nump">$ 79,412<span></span>
</td>
<td class="nump">$ 63,428<span></span>
</td>
<td class="nump">$ 136,103<span></span>
</td>
<td class="nump">$ 65,880<span></span>
</td>
<td class="nump">$ 63,698<span></span>
</td>
<td class="nump">$ 54,691<span></span>
</td>
<td class="nump">$ 268,629<span></span>
</td>
<td class="nump">$ 320,372<span></span>
</td>
<td class="nump">$ 324,914<span></span>
</td>
</tr>
<tr class="ro">
<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">$ 0.69<span></span>
</td>
<td class="nump">$ 0.72<span></span>
</td>
<td class="nump">$ 0.85<span></span>
</td>
<td class="nump">$ 0.68<span></span>
</td>
<td class="nump">$ 1.47<span></span>
</td>
<td class="nump">$ 0.71<span></span>
</td>
<td class="nump">$ 0.69<span></span>
</td>
<td class="nump">$ 0.59<span></span>
</td>
<td class="nump">$ 2.95<span></span>
</td>
<td class="nump">$ 3.47<span></span>
</td>
<td class="nump">$ 3.52<span></span>
</td>
</tr>
<tr class="re">
<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">$ 0.68<span></span>
</td>
<td class="nump">$ 0.72<span></span>
</td>
<td class="nump">$ 0.85<span></span>
</td>
<td class="nump">$ 0.68<span></span>
</td>
<td class="nump">$ 1.46<span></span>
</td>
<td class="nump">$ 0.71<span></span>
</td>
<td class="nump">$ 0.69<span></span>
</td>
<td class="nump">$ 0.59<span></span>
</td>
<td class="nump">$ 2.93<span></span>
</td>
<td class="nump">$ 3.45<span></span>
</td>
<td class="nump">$ 3.49<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_WeightedAverageNumberOfSharesOutstandingBasic', window );">Weighted average shares, Basic</a></td>
<td class="nump">87,810<span></span>
</td>
<td class="nump">90,984<span></span>
</td>
<td class="nump">92,987<span></span>
</td>
<td class="nump">92,859<span></span>
</td>
<td class="nump">92,756<span></span>
</td>
<td class="nump">92,589<span></span>
</td>
<td class="nump">92,181<span></span>
</td>
<td class="nump">92,360<span></span>
</td>
<td class="nump">91,104<span></span>
</td>
<td class="nump">92,431<span></span>
</td>
<td class="nump">92,422<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding', window );">Weighted average shares, Diluted</a></td>
<td class="nump">88,258<span></span>
</td>
<td class="nump">91,359<span></span>
</td>
<td class="nump">93,529<span></span>
</td>
<td class="nump">93,505<span></span>
</td>
<td class="nump">93,159<span></span>
</td>
<td class="nump">92,881<span></span>
</td>
<td class="nump">92,812<span></span>
</td>
<td class="nump">93,143<span></span>
</td>
<td class="nump">91,606<span></span>
</td>
<td class="nump">92,958<span></span>
</td>
<td class="nump">93,109<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>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_EarningsPerShareBasic">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/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_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_NetIncomeLoss">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/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://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(22))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873765&amp;loc=SL114874048-224260<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://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(18))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873790&amp;loc=SL114874131-224263<br><br>Reference 5: 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(20))<br> -URI http://asc.fasb.org/extlink&amp;oid=115205541&amp;loc=SL114868664-224227<br><br>Reference 6: 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><br>Reference 7: 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_NetIncomeLoss</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>credit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NetIncomeLossAttributableToNoncontrollingInterest">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of Net Income (Loss) attributable to noncontrolling interest.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://www.xbrl.org/2003/role/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 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (a)(2)<br> -URI http://asc.fasb.org/extlink&amp;oid=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 1A<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=114867106&amp;loc=SL7669619-108580<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_NetIncomeLossAttributableToNoncontrollingInterest</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
<td>us-gaap_</td>
</tr>
<tr>
<td><strong> Data Type:</strong></td>
<td>xbrli:monetaryItemType</td>
</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_NonoperatingIncomeExpense">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The aggregate amount of income or expense from ancillary business-related activities (that is to say, excluding major activities considered part of the normal operations of the business).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://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_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_QuarterlyFinancialInformationDisclosureAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<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_QuarterlyFinancialInformationDisclosureAbstract</td>
</tr>
<tr>
<td style="padding-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>
</tr>
<tr>
<td style="padding-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>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>91
<FILENAME>Show.js
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
// Edgar(tm) Renderer was created by staff of the U.S. Securities and Exchange Commission.  Data and content created by government employees within the scope of their employment are not subject to domestic copyright protection. 17 U.S.C. 105.
var Show={};Show.LastAR=null,Show.showAR=function(a,r,w){if(Show.LastAR)Show.hideAR();var e=a;while(e&&e.nodeName!='TABLE')e=e.nextSibling;if(!e||e.nodeName!='TABLE'){var ref=((window)?w.document:document).getElementById(r);if(ref){e=ref.cloneNode(!0);
e.removeAttribute('id');a.parentNode.appendChild(e)}}
if(e)e.style.display='block';Show.LastAR=e};Show.hideAR=function(){Show.LastAR.style.display='none'};Show.toggleNext=function(a){var e=a;while(e.nodeName!='DIV')e=e.nextSibling;if(!e.style){}else if(!e.style.display){}else{var d,p_;if(e.style.display=='none'){d='block';p='-'}else{d='none';p='+'}
e.style.display=d;if(a.textContent){a.textContent=p+a.textContent.substring(1)}else{a.innerText=p+a.innerText.substring(1)}}}
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EXCEL
<SEQUENCE>92
<FILENAME>Financial_Report.xlsx
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
begin 644 Financial_Report.xlsx
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MMWF\81AU8\K(XK%T-8943OTJDH\ Q:X831F:3LTXXFBD(3^ G/,6+V2?$9/
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M_O"["3MO[,'^8^.KH&SAUUW(+U!+ P04    " #1@DY.F5R<(Q &  "<)P
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M^\_<?,NA7QP&6G1C+QQ-#?GZ/U!+ P04    " #1@DY.;H^\,6P$  #P%
M&    'AL+W=O<FMS:&5E=',O<VAE970R+GAM;(V8[6ZK1A"&;\7R!1QV9[\C
MQU)-5;52*T6G:ON;Q)O8.F!<(/'IW7?!Q"(SLVG_Q$#>V7D'=I\=V%S:[EM_
MB'%8?6_J4W^_/@S#^:XH^J=#;*K^2WN.I_2?Y[9KJB&==B]%?^YBM9^"FKH
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M0[7==.UEU5V?UKD:)X6\4^EF/HT7IWLW_2]5VZ>K;UME-L7;.,XLV5TEL)#
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M*N SCGCB2@:Y&.R2HZG2ADPDJ@LRJ Q;)(]=2;EK\!X@&:*F/$%*[(@1>NO
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M-*CXD@8]Q&I_.ZGC\S >NG3<7;_!74^&]CQ_7RQN'SFW_P)02P,$%     @
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M>0L]241 ^A*QY\2 .#'GR% BQI\C(^(%&AH3Q)TC$X) 0],/1V7V<6_GI)W
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M.'IL,/U<@3'-&="<LS@F0'.;Z.@8LYQ1QRS@)OD,<T=X3N5M,&P-ZJSCQL"
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M#U]3^;X]W-8?'OKN^?A+A,GIYQ"W_P-02P,$%     @ T8).3E[N*>.O 0
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MX653_VM$#T'*YB:,4!L^V&PHJ'T\WH6S'<=L-#QVTP]B\S<N?@%02P,$%
M  @ T8).3GU5N0RT 0  T@,  !D   !X;"]W;W)K<VAE971S+W-H965T,30N
M>&UL?5/;;MLP#/T501]0)4K6!8%MH.DPM, &!!VV/2LV;0O5Q97DN/O[4;+K
M>9NW%TFD> X/*2H;K'OV+4 @KUH9G],VA.[(F"];T,+?V X,WM36:1'0= WS
MG0-1)9!6C&\VMTP+:6B1)=_9%9GM@Y(&SH[X7FOA?IQ V2&G6_KF>))-&Z*#
M%5DG&O@"X6MW=FBQF:62&HR7UA '=4[OML?3/L:G@&\2!K\XDUC)Q=KG:#Q6
M.=U$0:"@#)%!X':%>U J$J&,EXF3SBDC<'E^8_^8:L=:+L+#O57?917:G!XH
MJ: 6O0I/=GB J9YWE$S%?X(K* R/2C!':95/*RE['ZR>6%"*%J_C+DW:A_%F
M=YA@ZP ^ ?@,.*0\;$R4E'\00129LP-Q8^\[$9]X>^38FS(Z4RO2'8KWZ+T6
M^* 9NT:B*>8TQO!%S':.8,@^I^!K*4[\+SA?A^]6%>X2?/>;PG_DWZ\2[!/!
M_K\EKL7\J9(M>JK!-6F:/"EM;](D+[SSP-[Q]":_PL=I_RQ<(XTG%QOP95/_
M:VL#H)3-#8Y0BQ]L-A34(1[?X]F-8S8:P7;3#V+S-RY^ E!+ P04    " #1
M@DY.U:%AR+0!  #2 P  &0   'AL+W=O<FMS:&5E=',O<VAE970Q-2YX;6Q]
M4V%OW" ,_2N('U!R)%VK4Q*IUVG:I$TZ==KZF4N<!!7B#,BE^_<#DF;9%NT+
M8./W_&Q,/J%YL1V (Z]:];:@G7/#D3%;=:"%O<$!>G_3H-'">=.TS X&1!U!
M6C&>).^8%K*G91Y]9U/F.#HE>S@;8D>MA?EY H5300_TS?$DV\X%!ROS0;3P
M%=RWX6R\Q5:66FKHK<2>&&@*^G XGK(0'P.^2YCLYDQ")1?$EV!\J@N:!$&@
MH'*!0?CM"H^@5"#R,GXLG'1-&8#;\QO[AUB[K^4B+#RB>I:UZPIZ3TD-C1B5
M>\+I(RSUW%*R%/\9KJ!\>%#B<U2H;%Q)-5J'>F'Q4K1XG7?9QWV:;]*[!;8/
MX N KX#[F(?-B:+R]\*),C<X$3/W?A#AB0]'[GM3!6=L1;SSXJWW7DN>I#F[
M!J(EYC3'\$W,88U@GGU-P?=2G/@_<+X/3W<5IA&>_J$PVR?(=@FR2)#]M\2]
MF-N_DK!-3S68-DZ3)16.?9SDC7<=V <>W^1W^#SM7X1I96_)!9U_V=C_!M&!
MEY+<^!'J_ =;#06-"\<[?S;SF,V&PV'Y06S]QN4O4$L#!!0    ( -&"3DZW
M0UDWM0$  -(#   9    >&PO=V]R:W-H965T<R]S:&5E=#$V+GAM;'U388^<
M(!#]*X0?<"B[W=MLU.3VFJ9-VF1S37N?61V5'#@6<+W^^P)ZUK:F7X 9YKUY
M,PS9B.;%M@".O&K5V9RVSO4GQFS9@A;V#GOH_$V-1@OG3=,PVQL0501IQ7B2
M')@6LJ-%%GT74V0X."4[N!AB!ZV%^7D&A6-.4_KF>))-ZX*#%5DO&O@*[EM_
M,=YB"TLE-7168D<,U#E]2$_G?8B/ =\EC'9U)J&2*^)+,#Y5.4V"(%!0NL @
M_':#1U J$'D9/V9.NJ0,P/7YC?U#K-W7<A46'E$]R\JU.3U24D$M!N6></P(
M<SWO*)F+_PPW4#X\*/$Y2E0VKJ0<K$,]LW@I6KQ.N^SB/DXWAW2&;0/X#. +
MX!CSL"E15/Y>.%%D!D=BIM[W(CQQ>N*^-V5PQE;$.R_>>N^MX,DA8[= -,><
MIQB^BDF7".;9EQ1\*\69_P/GV_#=IL)=A._^4'B_3;#?)-A'@OU_2]R*.?Z5
MA*UZJL$T<9HL*7'HXB2OO,O /O#X)K_#IVG_(DPC.TNNZ/S+QO[7B Z\E.3.
MCU#K/]AB**A=.-[[LYG&;#(<]O,/8LLW+GX!4$L#!!0    ( -&"3DY#0YS?
MM $  -(#   9    >&PO=V]R:W-H965T<R]S:&5E=#$W+GAM;'U3VV[4,!#]
M%<L?4"?.%LHJB=0M0B"!M"JB/'N3R47U)=C.IOP]8R<-$41]L3WC<\Y</,XG
M8Y]=!^#)BY+:%;3S?C@RYJH.E' W9@"--XVQ2G@T;<O<8$'4D:0DXTGRCBG1
M:UKFT7>V96Y&+WL-9TO<J)2POT\@S530E+XZ'ONV\\'!RGP0+7P'_V,X6[38
MJE+W"K3KC286FH+>I\?3(> CX*F'R6W.)%1R,>8Y&%_J@B8A(9!0^: @<+O"
M T@9A#"-7XLF74,&XO;\JOXIUHZU7(2#!R-_]K7O"GI'20V-&*5_---G6.JY
MI60I_BM<02(\9((Q*B-=7$DU.F_4HH*I*/$R[[V.^S3?9-E"VR?PA<!7PEV,
MP^9 ,?./PHLRMV8B=N[](,(3IT>.O:F",[8BWF'R#KW7DB<?<G8-0@OF-&/X
M!I.N"(;J:PB^%^+$_Z/S?7JVFV$6Z=F6GB;[ H==@4,4.+Q9X@XF_;=(MNFI
M MO&:7*D,J..D[SQK@-[S^.;_(7/T_Y-V+;7CER,QY>-_6^,\8"I)#<X0AU^
ML-60T/AP?(]G.X_9;'@S+#^(K=^X_ -02P,$%     @ T8).3C>+6Q"T 0
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MN'!\[\]F'K/9<#@L/XBMW[C\#5!+ P04    " #1@DY.\TA7@;4!  #2 P
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MP+.=QFPRO.GG'\26;US\ E!+ P04    " #1@DY.(SSX_;0!  #2 P  &0
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MF["U;!TY&X\O&_M?&>,!I6RN<(0:_&"SH:#RX7B+9SN.V6AXTTT_B,W?./\
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M_&"SH:#RX?@)SW8<L]'PIIM^$)N_<?X74$L#!!0    ( -&"3DZM;W_UQ0$
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M3[CD2BD++I7DP>72N"F>#0&5]=N]V^OQ+8^&5=TTIF3^5^1_ 5!+ P04
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MPQN7$' HC&-@=KG" W#NB&P:;S,G7B1=X'K_P?[-UVYKN3 -#Y*_M*5I,GS
MJ(2*#=P\R?$1YGIBC.;B?\ 5N(6[3*Q&(;GV7U0,VD@QL]A4!'N?UK;SZSB=
M1/$<%@Z@<P!= @Y>ATQ"/O.OS+ \57)$:KK[GKE?O#U2>S>%<_JK\&<V>6V]
MUYSN:4JNCFC&G"8,76&V"X)8]D6"AB1.]+]P&@[?!3/<^?#=6OWP)4P0!0DB
M3Q#]4^+NIL00)@J+Q$&1.$ 0WXB$,$E8) F*) &"_8U("'.X$2&K[A"@:C\7
M&A5RZ/Q,KKS+Z-U3WUV?\&EN?S)5MYU&%VELC_I.JJ0T8%/9W-F"&_M4+ :'
MRKCMWN[5-#"3860_OP5D>9#ROU!+ P04    " #1@DY.Z4M,5[<!  #2 P
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M$/T5Q <L#D[B;&1;VFQ5M5(K15NU?2;V^*(%XP*)MW]?P([K>NF+889SF<%
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M?8_F@$-EW#2Q<S7>RC$PLI\>'#*_>OD?4$L#!!0    ( -&"3DYMV.[IV@$
M  $%   9    >&PO=V]R:W-H965T<R]S:&5E=#,S+GAM;&U4ZXZ<(!1^%<(#
M+,I<W$[49&>;IDW:9+)-V]^,'B]9$ LX;M^^@(ZU+G^$<_@NYR"0CE*]Z@;
MH#?!.YWAQIC^1(@N&A!,/\@>.KM22268L:&JB>X5L-*3!"<TBHY$L+;#>>IS
M%Y6G<C"\[>"BD!Z$8.K/&;@<,QSC>^*EK1OC$B1/>U;#=S _^HNR$5E4RE9
MIUO9(055AI_BTSEQ> _XV<*H5W/D.KE*^>J"+V6&(U<0<"B,4V!VN,$S<.Z$
M;!F_9TV\6#KB>GY7_^1[M[U<F89GR7^UI6DR_(A1"14;N'F1XV>8^SE@-#?_
M%6[ +=Q58CT*R;7_HF+01HI9Q98BV-LTMIT?QUG_3@L3Z$R@&P*9C'SE'YEA
M>:KDB-2T]SUSOS@^4;LWA4OZK?!KMGAML[=\%]&4W)S0C#E/&+K"Q N"6/7%
M@H8LSO0=G8;INV"%.T_?K>EQ%!;8!P7V7F#_7XN[38LAS#YL<@B:' ("AXU)
M"',,FQR#)L> 0+(Q"6$>PR9)T"0)"'S8F 0P[_X)61U! :KVET^C0@Z=O_BK
M['*_GZ@_PO_@T^/PC:FZ[32Z2F,O@C^NE90&;"G1@]W5QKY'2\"A,FZ:V+F:
M;N44&-G/#PY97KW\+U!+ P04    " #1@DY.7IO3/+$!  #2 P  &0   'AL
M+W=O<FMS:&5E=',O<VAE970S-"YX;6QM4]MNG# 0_17+'Q O9M-6*T#*)JI:
MJ956J=H\>V$ *S9#;;.D?U_;L(1N><$SPSEG+AYG(YI7VP(X\J959W/:.M<?
M&+-E"UK8.^RA\W]J-%HX[YJ&V=Z J"))*\9WNP],"]G1(HNQDRDR')R2'9P,
ML8/6POPY@L(QIPF]!IYET[H08$76BP9^@/O9GXSWV*)220V=E=@1 W5.'Y+#
M<1_P$?!+PFA7-@F=G!%?@_.URNDN% 0*2A<4A#\N\ A*!2%?QN]9DRXI W%M
M7]4_Q]Y]+V=AX1'5BZQ<F]-/E%10BT&Y9QR_P-S//25S\]_@ LK#0R4^1XG*
MQB\I!^M0SRJ^%"W>IE-V\1QG_2MMF\!G K\AL"E1K/Q).%%D!D=BIMGW(EQQ
M<N!^-F4(QE'$?[YXZZ.7(DV2C%V"T(PY3AB^PKPCF%=?4O"M%$?^'YUOT]/-
M"M-(3]?T)-T6V&\*[*/ _I\6^4V+6YC;)&PU4PVFB=MD28E#%S=Y%5T6]H''
M.WF'3]O^79A&=I:<T?F;C?.O$1WX4G9W?H5:_\ 61T'M@OG1VV9:L\EQV,\O
MB"W/N/@+4$L#!!0    ( -&"3DY!L/*[P@$  #<$   9    >&PO=V]R:W-H
M965T<R]S:&5E=#,U+GAM;'54[6Z;,!1]%<L/4 <2VBH"I*;3U$F;%'7:^MN!
M"UCU![5-Z-Y^MB&49MZ?V/=RSKGGVK[)1Z5?30=@T;O@TA2XL[;?$V*J#@0U
M-ZH'Z;XT2@MJ7:A;8GH-M XDP4FZV=P209G$91YR1UWF:K"<23AJ9 8AJ/YS
M *[& B?XDGAF;6=]@I1Y3UOX"?97?]0N(HM*S01(PY1$&IH"/R3[0^;Q ?";
MP6A6>^0[.2GUZH-O=8$WWA!PJ*Q7H&XYPR-P[H6<C;=9$R\E/7&]OZA_#;V[
M7D[4P*/B+ZRV78'O,:JAH0.WSVI\@KF?#*.Y^>]P!N[@WHFK42ENPB^J!F.5
MF%6<%4'?IY7)L(ZS_H46)Z0S(;TBD*E0</Z%6EKF6HU(3V??4W_%R3YU9U/Y
M9#B*\,V9-RY[+K?)+B=G+S1C#A,F76&2!4&<^E(BC94XI/_0TSA]&W6X#?3M
MFI[<Q@5V48%=$-A]:C&[:C&&^4^1+%HDBPC<716)8>ZOBI#5Q0G0;7BR!E5J
MD&%<5MEE*A[2</$?\&FD?E#=,FG025GW?,(E-TI9<%8V-\Y+YZ9X"3@TUF_O
MW%Y/;WD*K.KG,27+?T7Y%U!+ P04    " #1@DY.'V5@U;$!  #2 P  &0
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M*2XP+(:"8B@@9K)B3QTF&TW#"E9,5GX3HO*4Y7?$9*"8#!!#8 (&$K#YWBQ
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MGQ3D)-0PD&/6=A#M1-"ZZXZLOD6+_P-02P,$%     @ T8).3O<V_.K  @
MW0D  !D   !X;"]W;W)K<VAE971S+W-H965T-#4N>&ULC59M;]HP$/XK47Y
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M4[EFS<31; 0]F&$J:">ZZ7]02P,$%     @ T8).3IA-DSHP @  G 8  !D
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M]T_;Y8Z<*ZI-PB==K5)/RF'#Z%&9Y4*O13<NNHWB;3\*P3"/\_]02P,$%
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M[$\3==Z.'S_CA12-_K +IJ_+]3]02P,$%     @ T8).3G4..5N$ @  @@@
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M@!-4O<YG><H4TW!OYJHBI\6#O:$@#)W#L#2 H;,TF#", AA 53#T *8 80H
M)DBS+F9I4%G0 'DS5]$L?_"62I"E!%B"WVQ=SK(P4@2?^68N(H3E, H#41B
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MGD*%DN9:\PPTGN0%F9G@GBKX,%1G0%T]#"94#0WHSH"^,N %NT :A9T0=$+
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M]IK5J,P"L1!U^^^;0%0(I[O>",3G/>=-S@'"\"C*]VK+N70^\JRH1NY6RMW
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M9'PM]2E3YV6SH6\NI-B9CQ7O_,4T_@=02P,$%     @ T8).3L9ED4(U!0
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M)Z7<9=9"X$5V43P=9H8",2 C@_>0)JH.$28TI7!@!,;->OJ;]_2WH'"*GT3
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MW5.BW469;=LG8-[A,=SX?U!+ P04    " #1@DY.S>LE$WD"   S"0  &0
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M:1;"!(99"!/"9B/0; 0(&.7/(4QLF(4PYLY"F!5L-@;-QDL!SS',0ACCF]I
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MT3'VO)'V-]A?I.+MJ**MM/1E>-:=?=Y&_5<:3$A&0C(18O(I(1T)Z1L!?TK
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MFWM= M5'WA$ 4 DBSN:L %1<$@);UI</V-\0<&Y+M\$A_[3%L7<0()A_OBL
M]NZ #[:C68=NF3C9VT\&>W[IE&ETL]7IAGU(3(=WUM?FYK6=_TUFN+9_4G&J
M.QGLN-+WA^WR1\X5TR;1G2[K67\I3).&'949YGHLANMRF"C>CY\"T?0]LOH/
M4$L#!!0    ( -&"3D[@(A<I#P,  #$,   9    >&PO=V]R:W-H965T<R]S
M:&5E=#8U+GAM;(V7;W.B,!#&OPK#!SA(^.^H,[6V5>K-='IS=Z^I1F4*A(.H
MO6]_"4349:_EC9#X>W8WV0>)XQ.OWNL]8\+XR+.BGIA[(<J19=7K/<N3^ALO
M62&_V?(J3X0<5CNK+BN6;!I1GEG4MGTK3]+"G(Z;N9=J.N8'D:4%>ZF,^I#G
M2?5WQC)^FIC$/$^\IKN]4!/6=%PF._:#B9_E2R5'5A=ED^:LJ%->&!7;3LP[
M,EH%BF^ 7RD[U5?WAEK)&^?O:K#<3$Q;%<0RMA8J0B(O1W;/LDP%DF7\T3'-
M+J427M^?HS\V:Y=K>4MJ=L^SW^E&["=F:!H;MDT.F7CEIP73Z_%,0R]^Q8XL
MD[BJ1.98\ZQN/HWUH18\UU%D*7GRT5[3HKF>=/RS#!=0+:"=0.;^3.!H@7,1
MN)\*7"UPAPH\+?"&"GPM\(<* BT(A@I"+0B'"B(MB(8*B'WNG'V1^)]+NF:3
MP5G.[2842*S66(U3YXE(IN.*GXRJ?=;*1#W29"15,KB:;;S??"G=6LO9X]3W
MG+%U5)$T,VL9>L6$Y!:)^\B%L&0%71D4+6-&>WIZF^&^3X0 F?<1]Y9X0(*
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M]_+\W@TRMA7J-I#W57N*;0>"E_J ;G7_$J;_ %!+ P04    " #1@DY.I]V
MX:4#  "X$0  &0   'AL+W=O<FMS:&5E=',O<VAE970V-BYX;6R56-N.FS 0
M_17$!P1L<UTED38;5:W42JM6;9_9Q$E0 :?@;-J_K[DL)?8QVN0A >?,S)G!
M9["]O(KZ5W/B7#I_RJ)J5NY)RO.#YS6[$R^S9B'.O%+_'$1=9E+=UD>O.=<\
MVW=&9>%1WX^\,LLK=[WLQI[K]5)<9)%7_+EVFDM99O7?#2_$=>42]VW@:WX\
MR7; 6R_/V9%_X_+[^;E6=][H99^7O&IR43DU/ZS<1_*P97%KT"%^Y/S:3*Z=
M-I47(7ZU-Y_V*]=O&?&"[V3K(E,_K_R)%T7K2?'X/3AUQYBMX?3ZS?N'+GF5
MS$O6\"=1_,SW\K1R$]?9\T-V*>17<?W(AX1"UQFR_\Q?>:'@+1,58R>*IOMV
M=I=&BG+PHJB4V9_^-Z^ZW^O@_\T,&]#!@(X&-)@U8(,!&PW(O$$P& 2:@=>G
MTM5FF\ELO:S%U:G[QWO.VEE$'@)5_5T[V!6[^T^5IU&CK^LH3);>:^MHP&QZ
M#)U@R(CPE/<Q!$4A-M0PI[<!GDP$BVXA6Q.2Q)@$@WFRSI[=Y)EB!P%T$'0.
M@JF#R-<*U6/"#E/UF?K#1\OX/<@;4B$D%1JD" TU4CTFFH1B28PXF4":1@"X
M!1Z#.>X1Y!Z!@A*->V12B@/$'0!3AK@C8#+#/8;<8\!=F]2;'A-/(H5DD:8:
M<8 *%E3SM3514;Q(_<G'HL@$TD\ ?:;13\Q"):CR)BX,4>%-7#17]Q023\WY
MSG01IH:T="HF(B",6*D0'W=.'U0QT%NG;VH%B@\  U3O+0+&,X4DEKY/ /O0
MX@+V]4="W]]3">[*A $6D5Y#$\2L5''S)JA[6]X?!+=:$MZ1+>YX!+4\XV6+
M0+8XN#L1T)YBV_3 '8(D=V2+M4I,L8)G:X*LSY9B'5*@P]BV0,%BH.3]V5(L
M!DH!"_V5 $',$@<KA@+%Q'K7&4 W7<>?Z[84RX8"V<2VIX-E0^^0#<6RH4 1
ML3Z1(,BB<(IE0Y%L$HL++!MZAVPHE@T%LC&S12!+'(9EPX!L$LOT8%@V[ [9
M,"P;!A21Z*O  016RY98EBT D$Y"+2ZP(%AP1\98$,Q<LYL;B0%TDW$TES%6
M#@.B2/2%W@"Z60[-A<+B84 \B=Z7!M T%(%I>9/M:\GK8W<TT#@[<:EDNPN<
MC(['#X^TW?YJXQORL.T/$?Z[Z<\TOF3U,:\:YT5(M;GNML '(217//V%8GCB
MV7Z\*?A!MI>QNJ[[LX3^1HKS<$[BC8<UZW]02P,$%     @ T8).3K^A%'^J
M @  ] @  !D   !X;"]W;W)K<VAE971S+W-H965T-C<N>&UL?991;YLP$,>_
M"N)]8&,P4"61FD33)FU2U:G;LYLX"2I@9CM)]^UG&TJIN30/P3;_N]^=C7U>
M7(5\42?.=?#:U*U:AB>MN[LX5KL3;YB*1,=;\^8@9,.TZ<ICK#K)V=X9-76<
M($3CAE5MN%JXL0>Y6HBSKJN6/\A G9N&R7]K7HOK,L3AV\!C=3QI.Q"O%AT[
M\E]</W4/TO3BT<N^:GBK*M$&DA^6X3V^VV)B#9SB=\6O:M(.;"K/0KS8SO?]
M,D0V(E[SG;8NF'E<^(;7M?5DXO@[. U'IC6<MM^\?W7)FV2>F>(;4?^I]OJT
M#(LPV/,#.]?Z45R_\2&A+ R&['_P"Z^-W$9B&#M1*_<?[,Y*BV;P8D)IV&O_
MK%KWO [^W\Q@@V0P2$8#3#\U((,!>3=(/S5(!X/4,XC[5-S<;)EFJX44UT#V
MR]LQ^Q7AN]3,_LX.NLEV[\ST*#-Z6=$B6\07ZVC0K'M-,M'@41$;[R,B@1#K
M9&:>? 1LY@I"/TJV<TF1PT$0,$_B[,DT"$QA!RGH('4.T@\3Y06Y[C69T[3]
M1*$4(Y+"H P$90 H]T#9#)3G*"T0S*$@AP*<PN/0&><++9.2P)P<Y.0 I_0X
M^9R3$DQH 8,*$%3,027R0,5\A0A&14:\+Q+0?;:2)1A0"02$O8!Z33X!410E
M-_871O >1@ H\3=Q+[*/$97AJ/268C/HIA%E:91X[K: C.91B2:_6TG<.(@P
MD 3QD\! $C2BV0T4>"#=XP1 I3XJF:,HB;(;IPZ&CQU, -3L?"70E*?47YFY
M#/I6XLG1WW!Y=&55!3MQ;K4]02>C8^F^3VSI\,;7MJ2[DO+NIK\/_&3R6+4J
M>!;:%"97/@Y":&ZB1)'9-"=S!1D[-3]HV\Q-6_9UN.]HT0UWC'B\Z*S^ U!+
M P04    " #1@DY.LH._X,8"   3"@  &0   'AL+W=O<FMS:&5E=',O<VAE
M970V."YX;6R-EMN.FS 0AE\%<5_ G$Q62:0<5+52*ZVV:GOM)$Z"%C"UG63[
M]K6-EQ(SI+T)V/EGOIG!'GM^8_Q5G"F5WEM=-6+AGZ5LG\)0[,^T)B)@+6W4
M/T?&:R+5D)]"T7)*#L:HKL(XBO*P)F7C+^=F[IDOY^PBJ[*AS]P3E[HF_/>:
M5NRV\)'_/O%2GLY23X3+>4M.]!N5W]MGKD9A[^50UK01)6L\3H\+?X6>MBC7
M!D;QHZ0W,7CW="H[QE[UX/-AX4<Z(EK1O=0NB'I<Z896E?:DXOAEG?H]4QL.
MW]^]?S3)JV1V1- -JWZ6!WE>^(7O'>B17"KYPFZ?J$TH\SV;_1=ZI962ZT@4
M8\\J87Z]_45(5ELO*I2:O'7/LC'/F_7_;@8;Q-8@[@WB]*%!8@V2W@ ]-DBM
M0>H8A%TJIC9;(LERSMG-X]WG;8E>1>@I5=7?ZTE3;/.?*H]0L]=E/LOGX54[
MLIIUIXD'&M0K0N6]1\008AV/S.-[P&:L2)P8MF-)@>$@$C#/Q-@GPR!0#CM(
M00>I<9#>%0H[A>HTF=$T'23-DS2&.1G(R0!.X7"R$><#2I(DGT@H!T$Y )HY
MH'P$0BB>8>?C;,:R1WEC,!P\"@='D1,._E<X=YP"Y!0 !SF<3H.'^> @FUCT
M,Q S S#.LE]W&A3=<Y("YF@=M($C@)2X.S@"47GF?$BK^\_,T41+04!$J1L1
M@DB#@.Y)8&=9H1@@92X)$DTL&00W#Y0 +MS-#XJF.'"/0>,F@R-W\UM1,:Q<
M4+@?<BS* J<R6T"4!U.K#^Y6:-RN<.1V$2N:#3A1,-&]$=RLT+A;8>2V!RLJ
M'G+"P<E84WXRMP[A[=FED?J &<SV-YM5K$]69WZM;SSFQ/WKIKLN?27\5#;"
MVS&ISFUSNAX9DU3%& 6J%F=U0^L'%3U*_8K5.^^N*=U LM9>P<+^'KC\ U!+
M P04    " #1@DY.[: ""=("  "A"P  &0   'AL+W=O<FMS:&5E=',O<VAE
M970V.2YX;6R55NUNFS 4?17$ Q1L#(8JB;2D7Y,VJ6JU[;>;. DJ8 9.TKW]
M;.-& 5]:FA_!-N<<']]KKN[L))K7=L^Y]-[*HFKG_E[*^CH(VO6>EZR]$C6O
MU)NM:$HFU;39!6W=<+8QI+((<!@F0<GRRE_,S-ICLYB)@RSRBC\V7GLH2];\
M6_)"G.8^\M\7GO+=7NJ%8#&KV8X_<_FK?FS4+#BK;/*25VTN*J_AV[G_#5T_
M(*H)!O$[YZ?V8NSIH[P(\:HGWS=S/]2.>,'74DLP]3CR%2\*K:1\_+6B_GE/
M3;P<OZO?F<.KP[RPEJ]$\2??R/W<3WUOP[?L4,@G<7K@]D"Q[]G3_^!'7BBX
M=J+V6(NB-?_>^M!*45H59:5D;]TSK\SS9/7?:3 !6P(^$Q#YD!!90C250"R!
M3"7$EA!/)226D$PE4$N@4PFI):0#0M"EP^3WADFVF#7BY#7=%:V9_A+0=:IN
MT%HOF@MCWJD4MVKUN* (S8*C%K*898?!/0SN8U8N9H"X<1&DC[C]5./.141)
M'W+O0E+:ASQ YXG.F$#%ZQPT# 8-&X&H)T!@@0@4B(P Z0G$ Y<=)C&8RF#B
MT/[@K0BX%0&V&L3LECA;12%&26^K+@$NDH8HPP[PW@4F*,7IJ/D8-!\[YM%8
MH!-0()F>*0H*T GAHT!0W-"Y*.2B[EU4-AJS%'2<NC'#V<!QAXE[C@ER/;LX
M%$:IZ]K%9209]9V!OC/'=T)'!% (U[)P>K;12#E$0+[IL)(AY[@QR<)L6*Q<
M6)3BF(X8@DL-PH"A=&@(.[<&QR%P!R$@^J"D(+A\(:A^92,2<%E"Y NY@HL#
M<JL#Q>&PUL=CH1D],UQ)4/)Y)5A:T%=V@\L.<NN.\Q4O+>CR@A$,I'T% !&%
M3 47;8-N7G^R9I=7K?<BI.I 3)^P%4)R)1I>*;F]ZI?/DX)OI1Y2-6ZZIK&;
M2%';AC@X=^6+_U!+ P04    " #1@DY.%1_VG_,!  #=!   &0   'AL+W=O
M<FMS:&5E=',O<VAE970W,"YX;6Q]5.V.HR 4?17B Q1%^Y%&3:9M-K/);M+,
M9G=^4[VM9D <P#K[]@OH6&O=^2-P.>=PSY5+W KYI@H C3XXJU3B%5K76XQ5
M5@"G:B%JJ,S.64A.M5G*"U:U!)H[$F>8^/X*<UI67AJ[V%&FL6@T*RLX2J0:
MSJG\NP,FVL0+O,_ 2WDIM W@-*[I!7Z!_ET?I5GA024O.52J%!62<$Z\IV![
MB"S> ?Z4T*K1'%DG)R'>[.)[GGB^30@89-HJ4#-<80^,62&3QGNOZ0U'6N)X
M_JG^S7DW7DY4P5ZPUS+71>)M/)3#F39,OXCV&7H_2P_UYG_ %9B!VTS,&9E@
MRGU1UB@M>*]B4N'THQO+RHUMM[->]K1Y ND)9" $JR\)84\(;X3H2T+4$Z()
M 7=67&T.5-,TEJ)%LON[-;67*-A&IOJ9#;IBNSU3'F6BUW1-@AA?K5"/V748
M,L+<$-BH#T>0N2-VY(%.[@_8/R+"U3WD\ C9K.>3"&=]AHX?CI,@_W$1S0I$
M3B"Z*]3$QZ[#;!RF<ICE<K&9F)T!^8OUQ.XC*%HNR"1?//K)'.3%-9!"F6@J
M;6LUB@X]^D3L)9G$=Z9WNU:[R72-_Y/*2UDI=!+:7$%W4<Y":# Y^@O3385Y
M:X8%@[.V4],;2'8=URVTJ/O'! \O6OH/4$L#!!0    ( -&"3DZ/\[/N\ $
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MR8708#)<K\PLE>:E&0T&N;;;K=G+?MYZ0XMF>$K0^)XE_P%02P,$%     @
MT8).3H-ZN7X' @  RP4  !D   !X;"]W;W)K<VAE971S+W-H965T-S(N>&UL
M=93=CML@$(5?Q?(#+!C_1XZE9JM5*[52M%7;:Y),8FNQ\0*)MV]?P([EM<E-
M8/"9\\T0H.BY>),5@/(^&M;*K5\IU6T0DL<*&BJ?> >M_G+FHJ%*A^*"9">
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M+^L4,#@K,TWU7 SORQ HWHU/)YK>[_(_4$L#!!0    ( -&"3DXAW+/9)@@
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M(C[[&=-6/:9'$X(YZ[&F.248CW3)\4AGG$VJH9JG&XH[6A9W\N$)HM=0. W
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M'T_U]@&5[D>8&*LY_9__2SX:CZA&Z%TA6@/+U=[<I1&^Y-FQ\8GM;N]@&JC
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MZ0XDNF,"&5/Z  8I/DKSQR#P :F-F7&-4\GM??T(9,<A.M*)=PON3CS+( -
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M8R<F.XJ>4PG; OOA7(^GH[-GX"#DATY,"-,DW,LT6^)][_/ 5726[?0'S^G
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M(?Q*^(8O :&(2/!-X[X$Y-_CI8G_Z%@9Z'XN=XUUYS-/B8L,T_NJ@R2 >8*
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M5FZ!7HVY5JBF@F90- ].])H!%7V,7I&F%RW!VP6(U%$0FW'BC8,SI53:H#(
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M'KB6D[$9JN64]-7+;2@-;?EGT>+]'NU.N55=Z+N=6H_V(5<G,E*5(8(C%T1
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MOT 3)-P&1DZ2>+I<(TV 2&F*-)EBS@3OWG(9KQ8SG.ERMHDWZ?JW!;*MGC8
M.CA6JD@!8W2E=:.FUT1@W1X8W?$&A:!%$+BU" (:Z="B7(M\AN-^$=B84LA]
MB1;,A:+9 MOX6@]NTQ^X4JD'GHMJ_RI5$6_0?=?=K(CE5#G?!]*"^\>XFQ71
MJ08<G:&[L_M3=7'[_'-K5!5)T40=^)PS140P&4S8 09;S%+X5SJ-%L!ARPW^
M/8E 5JQ6"?X]Q5J?=$X_GR%OS^?K:+3^Y)TJ"WPMH8_OQ$W?RW7B9QO_,&8#
MCF=WK%4QRL!WC/V.*D<Y5Z7XVV2S2H#J?>4%/C!=4"(4"LC46!* R9S5MD+\
MKBJI%!:("E)E'J4@#N?IQCT,PZ$?6T#&Z T+ +&>4KW&:A$O5W[T090Y:D,\
M!Y&4@" '>><?'XVV +>NEM,(MGOA9^/<T9MXOEIA<=9F(44)/8K.Y_@A9)XE
M7&!8);:)9W.J%P-Y!S0;X!L:81!-L.BSS!\))#=Z@_; +\I5>XYM-I-HZ#-&
M?>;5I4RQ(66#)*3)+NT!98S,.YE<YD6ZF(YA)\3:.1_"[AGGS"1U2AP<$BJ:
M;7QBB@1,PS2O\"/DKPU&X:QG_H %_N,R^GE7$&)RT&HL%>T7G7/DH/$PS4R/
M@\ SH1_9F8D>*5'<QD-EQZ;'?LZ+.QJ3"**MABT)*D(*X8Y\ 4JG5"99^E6;
M$%;306>2>JDC*A38=M%(Q8%^F4)LUZ"$0%-MUNQ@0U'!R9P(XIM84IV0U2#+
MVF,[!DYY7;6+":XU(N+X97-MU9O=K SQ_NX+@K1#<I*F\P+4QFF<K#'!$^XB
M$+2I_&V1KM"/UVOZX, S56I0$J>K);P5K^![4F6)*;+21OG&QT>YIS">D #1
MX14HB\RE-"L0L?,UW(LP[B9!K2X!2?X.8\Y"0*I4W8#TW,!C-R3J0=TSO])6
MA/V;Y5L@15=KD*(XU7F4I/%JFI@WA)%I8;;'YW.S6"PP,78%<AC_6"[A8WH^
M-S NEI+"+\$V2.8S2J,%S3R9^FG9S]PL4K@,YO+PFH=.X+45#JNV2SH;V8V:
M8XUD,K1EQ*\E@8M[9]E%7AT[-_WPRX 89T>Z=79HA;<,0OQR"-WBR5<@L]LJ
M&L?&=W.O]GOLY0#GE(!OX=;6[J&VSDN'M]1'G.#OJ3;2G(!F?4V%K?2P#&*8
M05B3[B8H_%/.^UA\QP0TU&+F_[MED[!QV8?LFQ#T7/(_!1[MKA+PHZ BO!%$
M"%\4[ZKYWT@6PH]$T5\\!D1W+'KCMP<CDBFBUEZ:CAF=SJM!!SF/%+UVJ3R2
MF">=W$#A  W$1C \+$*=?ZH.G\C5Q@/LLRVS!2-D2B9\!G?W2J5Q-*>[6_LD
M3Z?[>50R"?*977^8RH&76IG96CV-KJRQ4OU3NB-&-V+OW+F9JT%RBJH4&I)2
M&S/D;&6[B>GB)1U1,X=<#%)ZC1U!%4<R60N)#ME3$_>F+JXHT\F34E/%"B_"
MU'/=+X_9Q]QI!!QDW&'MD^2G4$*MFB>I*44YB=YFQ8'"@^'$V%3V=&/P=EQ=
M6Q#X)R:,?!+-9)?O,TP]\. ZO'7&;1V1# =V4'N4^#6Z/DS2)+!KP8_@$+3"
M4)%H1Y=#*./*<9BKAW+L@GE+.POKC-\\4 55HPPUM3 C"].19,G1X^8^+O''
M]H(-\01MT6F/,'[&E)?D1".(Q<588E*&LO(3AXSV><U:C'FQ6@1(0??W")+2
MYKZ5DPH)>G030JUSB33G\J%&/KN8?M%G5_:SOPX(;PV-XRGE)^L\J'X@:C+@
M"@LM5+@700+5(IV7GB6KZY@;!VGN<&Y5[9^^RVPJNVM?X+YF!O<1X[\L*L2/
MK.=/EZ5-CS4V[L?P-(_4,*H\'2V4I#5'FOQ8W'(M+-6\8O4::5M@)OSI!+(^
MH3<<\R2#<UCUYL =0&4.R]\V!^STYS L%_36GTX'_'OL$1 Y^>K@LQ+L*<%
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M%7MCJ[UMY^?UK!Z;PVU,S4CIXD OZFU1WHJQ.>G^(# V'C(^)6=D*^<16(4
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MFSC=<-+H8CE9+LQ?>+";.;:J77(:['(V6:S"3\T2[GZ$K68G\R73VAVR(1#
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M,5 >XBQ1HYQD.HOGJW4OX]+6)OY/]K? 0?%JZ0\^>ME][\+C5]I.*S!#SDS
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MY*VS:4@6HUDW'<_W)W3)?O*@770%':C[.CO7)RXTT7DA=!_,!(.<0IMWIX*
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M8N%A[D".@:16W][F>K^(3SK1.6KL%FOZ$U41MM 1C%N 54$UVY/>C6VC\;
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M'B"K^AE:"TD;@.%@P#%:'D&Z37)T/G8A*$IXH&Z5#0$$RZX!=IL:UF=-FTR
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M:3>3C8+2@K:CNY+!8H:9L=M'52U'7F' C%<B8*%5T["?7=SN]B!S(2KA#=9
M!UWT KI^_#:S0R+1-I8!QT/_&@8H=AD>G!:4GYJ<HQVH,757S\R^4Z[MGT&9
M14Z%X#^.+U]YYFMXF1;$V3K'&"S\K!8-O%%=-2!V9E;S)T2(<&(7-UYWN#_K
MJDJ(:('_RZHNR4'C:K/97P0FDTR==T("=?LL;1<-G&NXWT'6AG.>HLQ=T7EO
MVLXM\T"$;)4UKT'=+?"C0C[4HH*-O;==)E5)9LA-UX!L528-*,LY**7X68)*
MVD+##(Z*E%@)0,Q"?P;A#"2S DX;J,9-EZ!>F=4YG:NJ*:WB)]:,2?$&- A0
M.D'S!8D,;C/XMZM1'Y(1"RI^!AUK74&^V!R%K%+^U;12*:<8EA.*J2/ *%V\
M +<QFEDL)&I= @R&#BR@(O=@@P'"P(\QBK>14X2,QTS3/*N1LY#Z 2]8"L\P
MS&PF1@,M<5QJEC3RGP5YA//9-C1!%<@'G0B]:>'%FY2WPLWSDN)14%5+<1&H
M*S0.%7(*,+)*:/JR*Y03R.7^ A9T45*D;%W!2E0DD"Q :)Q],,@"$>F6#BJ\
M(YQ50_]GB9^ =TS=T@<I6G#CY.)+V)M2C@T_T_IRMZ, J%Y EF[A]5&DAHGK
M\&26.(UMENI>0-"NX&#@1]ZA$%Y B[8EK10&/WOIJ4B&%=G0^KH<"B8>VBQ0
MH0+JNI[+I%]E%MFO\H@9#NOWHU K*?3.I*<C@B7)&;)Z]E)H7Y.98UN@]P*9
M8UO"E)4H@[9U"_I(ELA@PCP]A#E63;Y NT-59V39JMH:[LPZJ>&Z+:MJ*G/,
M&[+\X1T..P+82PF#+M#'4HQDC@6<UHH^R3^3"E,$,LVVJX:88[6HX= B?P>>
M A\9*+C *DLX&6'F"*.LZA0^4<"'3YC@*D,FB>V;,'.L*0 WPV27%(-;H)\"
M11/H/2VBS+&""2[0=82CA,N 98SHYLHE*ZH*Q91*82X%1M62X44RQCD:?$_&
M\D>\$$!'[I#CI-*RJ"-F?.98-"(O IE<IL91%/*[HLX&F&,'%V8K;A.0U^C>
MZSI:4I"A;?8XU_SQ1+MNYA@I1P$,\S(E_SG^E</2=")VM($KW.&250F20B;8
M9=VU@DNVI)YE!5R?L#B3V&0>9),43XB,4;! <G$OR\9AD_PSC,4DQ"8+V)OP
MD;5D(JE:8II-5=ML$HU^R%'A3L /?)3R)V8P^/^7;/*(+,Y3&\7+$>=?K4&#
MO3N!)SY=O4KF+U!%@Q/S3D0Y>2K,;YO?E\C)2!#N_P@:X5)+R?T?08S6/_JQ
M"O)5W@^_RM\HI.P-5N?YSSX9>?!5_8@_@+=BZ+9=NQ+>[>^;6ZQT"5\\^8;(
MLENFJ>?X.P\BLJA*;,D-(>-M.77FS*\S(P*<MZM; _C"EIP19:N=<C-LF1E9
MID3!P=VO_DDJYG<FDOO/%?_U.Q\UQ=B0V DQ,!9N1).+9<$E(PXB$P0@)[Q7
MH>QH&47V26='B_"A5RK-^F_O2('SM@N%()J\?!,[O&." JBK_I?UB/Z;8/\U
M1_+3 ^81H,5BAQB/<#']2OOUL]BO06)%LZS\C6OE,YUK.)CS#=E*Y;1?WN[_
MH:DF_^*R'(.=?O!2P9C<Q'ZCC#UBZ*?WOU4Y1OOP$'BO+5^];\%O?564SSL2
M\AB%^G[+9L]JEJ!.HS*K>5S/Y#(?U#ZCKP>3CYSB)/VG\Y&O#AOCG:Q$:'*Y
M0O/2C*9Y+DL9CB#*M+ZRBQ[J_[PR]1. /F:X32!YH4HGAAM)\]W8WR?-7!&8
M.9_FE)GS6Q\]<S[)X9F;)+",!)BP)1A@!1B_%.5O0'B%UL1+E;(JB8E$OO#0
MUU]I5BYUV1%;BHK))+;.ZJ!5>*<Y33D.V >J$$X,@P-QY0)5!#=6S1$O6*9;
ML RZAWD1[*AB2;;<MP8HXPQ5?2H'=3- /\LY2BQY]I4U"L<%H7"\4R@<81ZA
M4Y/55@D^R[ZZ6:IS ]D1G#V.@HVSX1X,!\PC(,I_5 ;JF+?CE_7=S>GCYE3?
M/5?&>1O;W>8*8^]&[@<#UD'RE]U18%)4 .<OJ,N^182.$8WZ^!RO)#Y'Z/GP
M)$\$WYB^$*/0,L*-8E 9AT!AN&\? KV8_IJ& *S:V9<]3:JW#D&("R9P\B!D
MB^.GQ,$-F;S8M_N5=*[*0!=%*CPG$22+_J.C0"N>9PH^R!&IZ]BZH3]^WPJ
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MX0\:I_92!"&C[>BGI6'7//_3?O_XY_\!4$L#!!0    ( -&"3D[>Y$3T1P(
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M8IBU'"@B/-J?(*4UOVX+CJ_I^!M02P,$%     @ T8).3G;;4X*%!0  IS
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M(M+Z6C?U55#]G]VG?479?V&SV#3-&:W[VUUZW:\?SO'X/P+O_P-02P,$%
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MN7^B]#!NR>[Z>O,_[W7JGP@WK2A/OP%02P,$%     @ T8).3LX6WG8. @
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MHR3WSNW>YK/Y_ZQ7SU!+ 0(4 Q0    ( -&"3DX?(\\#P    !,"   +
M          "  0    !?<F5L<R\N<F5L<U!+ 0(4 Q0    ( -&"3DXGZ(<.
M@@   +$    0              "  >D   !D;V-0<F]P<R]A<' N>&UL4$L!
M A0#%     @ T8).3H7N@;SN    *P(  !$              ( !F0$  &1O
M8U!R;W!S+V-O<F4N>&UL4$L! A0#%     @ T8).3IE<G",0!@  G"<  !,
M             ( !M@(  'AL+W1H96UE+W1H96UE,2YX;6Q02P$"% ,4
M" #1@DY.K*:!_-H"  "<"P  &               @ 'W"   >&PO=V]R:W-H
M965T<R]S:&5E=#$N>&UL4$L! A0#%     @ T8).3FZ/O#%L!   \!0  !@
M             ( !!PP  'AL+W=O<FMS:&5E=',O<VAE970R+GAM;%!+ 0(4
M Q0    ( -&"3D[PT519)P(  "4'   8              "  :D0  !X;"]W
M;W)K<VAE971S+W-H965T,RYX;6Q02P$"% ,4    " #1@DY.!FCW^3X(   D
M+0  &               @ $&$P  >&PO=V]R:W-H965T<R]S:&5E=#0N>&UL
M4$L! A0#%     @ T8).3J]R'#",!0  JQT  !@              ( !>AL
M 'AL+W=O<FMS:&5E=',O<VAE970U+GAM;%!+ 0(4 Q0    ( -&"3DXOBWK1
M7P8  !HA   8              "  3PA  !X;"]W;W)K<VAE971S+W-H965T
M-BYX;6Q02P$"% ,4    " #1@DY.7NXIXZ\!  #2 P  &
M@ '1)P  >&PO=V]R:W-H965T<R]S:&5E=#<N>&UL4$L! A0#%     @ T8).
M3IE*JR"T 0  T@,  !@              ( !MBD  'AL+W=O<FMS:&5E=',O
M<VAE970X+GAM;%!+ 0(4 Q0    ( -&"3DZM3_,@M@$  - #   8
M      "  : K  !X;"]W;W)K<VAE971S+W-H965T.2YX;6Q02P$"% ,4
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M+GAM;%!+ 0(4 Q0    ( -&"3DY]5;D,M $  -(#   9              "
M 3PU  !X;"]W;W)K<VAE971S+W-H965T,30N>&UL4$L! A0#%     @ T8).
M3M6A8<BT 0  T@,  !D              ( !)S<  'AL+W=O<FMS:&5E=',O
M<VAE970Q-2YX;6Q02P$"% ,4    " #1@DY.MT-9-[4!  #2 P  &0
M        @ $2.0  >&PO=V]R:W-H965T<R]S:&5E=#$V+GAM;%!+ 0(4 Q0
M   ( -&"3DY#0YS?M $  -(#   9              "  ?XZ  !X;"]W;W)K
M<VAE971S+W-H965T,3<N>&UL4$L! A0#%     @ T8).3C>+6Q"T 0  T@,
M !D              ( !Z3P  'AL+W=O<FMS:&5E=',O<VAE970Q."YX;6Q0
M2P$"% ,4    " #1@DY.\TA7@;4!  #2 P  &0              @ '4/@
M>&PO=V]R:W-H965T<R]S:&5E=#$Y+GAM;%!+ 0(4 Q0    ( -&"3DXC//C]
MM $  -(#   9              "  <!   !X;"]W;W)K<VAE971S+W-H965T
M,C N>&UL4$L! A0#%     @ T8).3FJ*/Y^S 0  T@,  !D
M ( !JT(  'AL+W=O<FMS:&5E=',O<VAE970R,2YX;6Q02P$"% ,4    " #1
M@DY.99'^E[0!  #2 P  &0              @ &51   >&PO=V]R:W-H965T
M<R]S:&5E=#(R+GAM;%!+ 0(4 Q0    ( -&"3D[CK&<-M0$  -(#   9
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M970R-RYX;6Q02P$"% ,4    " #1@DY.Z4M,5[<!  #2 P  &0
M    @ %)40  >&PO=V]R:W-H965T<R]S:&5E=#(X+GAM;%!+ 0(4 Q0    (
M -&"3DX]AV<$Q@$  #<$   9              "  3=3  !X;"]W;W)K<VAE
M971S+W-H965T,CDN>&UL4$L! A0#%     @ T8).3L#L,LVW 0  T@,  !D
M             ( !-%4  'AL+W=O<FMS:&5E=',O<VAE970S,"YX;6Q02P$"
M% ,4    " #1@DY.]=V,!K8!  #2 P  &0              @ $B5P  >&PO
M=V]R:W-H965T<R]S:&5E=#,Q+GAM;%!+ 0(4 Q0    ( -&"3DY_25ZGX $
M  $%   9              "  0]9  !X;"]W;W)K<VAE971S+W-H965T,S(N
M>&UL4$L! A0#%     @ T8).3FW8[NG: 0   04  !D              ( !
M)EL  'AL+W=O<FMS:&5E=',O<VAE970S,RYX;6Q02P$"% ,4    " #1@DY.
M7IO3/+$!  #2 P  &0              @ $W70  >&PO=V]R:W-H965T<R]S
M:&5E=#,T+GAM;%!+ 0(4 Q0    ( -&"3DY!L/*[P@$  #<$   9
M      "  1]?  !X;"]W;W)K<VAE971S+W-H965T,S4N>&UL4$L! A0#%
M  @ T8).3A]E8-6Q 0  T@,  !D              ( !&&$  'AL+W=O<FMS
M:&5E=',O<VAE970S-BYX;6Q02P$"% ,4    " #1@DY.0IZQ>;8!  #2 P
M&0              @ $ 8P  >&PO=V]R:W-H965T<R]S:&5E=#,W+GAM;%!+
M 0(4 Q0    ( -&"3DZ3P1#@+ 0  ' 7   9              "  >UD  !X
M;"]W;W)K<VAE971S+W-H965T,S@N>&UL4$L! A0#%     @ T8).3LS:6LR^
M @  '@P  !D              ( !4&D  'AL+W=O<FMS:&5E=',O<VAE970S
M.2YX;6Q02P$"% ,4    " #1@DY.83,NT(@"  !$"0  &0
M@ %%;   >&PO=V]R:W-H965T<R]S:&5E=#0P+GAM;%!+ 0(4 Q0    ( -&"
M3DZ\#0Y*W@$  ,<$   9              "  01O  !X;"]W;W)K<VAE971S
M+W-H965T-#$N>&UL4$L! A0#%     @ T8).3D*?XW#P 0  ^00  !D
M         ( !&7$  'AL+W=O<FMS:&5E=',O<VAE970T,BYX;6Q02P$"% ,4
M    " #1@DY._TQ_7S<#  # #   &0              @ % <P  >&PO=V]R
M:W-H965T<R]S:&5E=#0S+GAM;%!+ 0(4 Q0    ( -&"3DXOUACT? (  *X)
M   9              "  :YV  !X;"]W;W)K<VAE971S+W-H965T-#0N>&UL
M4$L! A0#%     @ T8).3O<V_.K  @  W0D  !D              ( !87D
M 'AL+W=O<FMS:&5E=',O<VAE970T-2YX;6Q02P$"% ,4    " #1@DY.F$V3
M.C "  "<!@  &0              @ %8?   >&PO=V]R:W-H965T<R]S:&5E
M=#0V+GAM;%!+ 0(4 Q0    ( -&"3DY#5>5\8P(  )L'   9
M  "  ;]^  !X;"]W;W)K<VAE971S+W-H965T-#<N>&UL4$L! A0#%     @
MT8).3IR]T[L[ P  :0X  !D              ( !68$  'AL+W=O<FMS:&5E
M=',O<VAE970T."YX;6Q02P$"% ,4    " #1@DY.=0XY6X0"  """   &0
M            @ '+A   >&PO=V]R:W-H965T<R]S:&5E=#0Y+GAM;%!+ 0(4
M Q0    ( -&"3DY4**B!+@,  -\-   9              "  8:'  !X;"]W
M;W)K<VAE971S+W-H965T-3 N>&UL4$L! A0#%     @ T8).3F54F)/F 0
M^ 0  !D              ( !ZXH  'AL+W=O<FMS:&5E=',O<VAE970U,2YX
M;6Q02P$"% ,4    " #1@DY.#/M=[&,"  "U!P  &0              @ $(
MC0  >&PO=V]R:W-H965T<R]S:&5E=#4R+GAM;%!+ 0(4 Q0    ( -&"3DZ:
MUATW.0(  -\&   9              "  :*/  !X;"]W;W)K<VAE971S+W-H
M965T-3,N>&UL4$L! A0#%     @ T8).3N*_3Q7A @  :@H  !D
M     ( !$I(  'AL+W=O<FMS:&5E=',O<VAE970U-"YX;6Q02P$"% ,4
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M+GAM;%!+ 0(4 Q0    ( -&"3D[7K@/(O0$  "8$   9              "
M 6*A  !X;"]W;W)K<VAE971S+W-H965T-3DN>&UL4$L! A0#%     @ T8).
M3C)+&T-; P  /0T  !D              ( !5J,  'AL+W=O<FMS:&5E=',O
M<VAE970V,"YX;6Q02P$"% ,4    " #1@DY.QF610C4%  "2&P  &0
M        @ 'HI@  >&PO=V]R:W-H965T<R]S:&5E=#8Q+GAM;%!+ 0(4 Q0
M   ( -&"3D[-ZR43>0(  #,)   9              "  52L  !X;"]W;W)K
M<VAE971S+W-H965T-C(N>&UL4$L! A0#%     @ T8).3J6$L;H% P  S@L
M !D              ( !!*\  'AL+W=O<FMS:&5E=',O<VAE970V,RYX;6Q0
M2P$"% ,4    " #1@DY.2@#'6)<"  ";"   &0              @ % L@
M>&PO=V]R:W-H965T<R]S:&5E=#8T+GAM;%!+ 0(4 Q0    ( -&"3D[@(A<I
M#P,  #$,   9              "  0ZU  !X;"]W;W)K<VAE971S+W-H965T
M-C4N>&UL4$L! A0#%     @ T8).3J?=@.&E P  N!$  !D
M ( !5+@  'AL+W=O<FMS:&5E=',O<VAE970V-BYX;6Q02P$"% ,4    " #1
M@DY.OZ$4?ZH"  #T"   &0              @ $PO   >&PO=V]R:W-H965T
M<R]S:&5E=#8W+GAM;%!+ 0(4 Q0    ( -&"3DZR@[_@Q@(  !,*   9
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M970W,BYX;6Q02P$"% ,4    " #1@DY.(=RSV28(  !1+   &0
M    @ &FRP  >&PO=V]R:W-H965T<R]S:&5E=#<S+GAM;%!+ 0(4 Q0    (
M -&"3DXMO%R#[(H  )04 @ 4              "  0/4  !X;"]S:&%R9613
M=')I;F=S+GAM;%!+ 0(4 Q0    ( -&"3D[>Y$3T1P(  %H+   -
M      "  2%? 0!X;"]S='EL97,N>&UL4$L! A0#%     @ T8).3G;;4X*%
M!0  IS    \              ( !DV$! 'AL+W=O<FMB;V]K+GAM;%!+ 0(4
M Q0    ( -&"3DY-SLSM7 (  - K   :              "  45G 0!X;"]?
M<F5L<R]W;W)K8F]O:RYX;6PN<F5L<U!+ 0(4 Q0    ( -&"3D[.%MYV#@(
M -<J   3              "  =EI 0!;0V]N=&5N=%]4>7!E<UTN>&UL4$L%
3!@    !2 %( <!8  !AL 0    $!

end
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>93
<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 {
	border-bottom: 0px solid black;
}

/* styles for footnote marker */
..report .fn {
	white-space: nowrap;
}

/* styles for numeric types */
..report .num, .report .nump {
	text-align: right;
	white-space: nowrap;
}

..report .nump {
	padding-left: 2em;
}

..report .nump {
	padding: 0px 0.4em 0px 2em;
}

/* styles for text types */
..report .text {
	text-align: left;
	white-space: normal;
}

..report .text .big {
	margin-bottom: 1em;
	width: 17em;
}

..report .text .more {
	display: none;
}

..report .text .note {
	font-style: italic;
	font-weight: bold;
}

..report .text .small {
	width: 10em;
}

..report sup {
	font-style: italic;
}

..report .outerFootnotes {
	font-size: 1em;
}
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>95
<FILENAME>FilingSummary.xml
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
<XML>
<?xml version='1.0' encoding='utf-8'?>
<FilingSummary>
  <Version>3.10.0.1</Version>
  <ProcessingTime/>
  <ReportFormat>html</ReportFormat>
  <ContextCount>172</ContextCount>
  <ElementCount>383</ElementCount>
  <EntityCount>1</EntityCount>
  <FootnotesReported>false</FootnotesReported>
  <SegmentCount>73</SegmentCount>
  <ScenarioCount>0</ScenarioCount>
  <TuplesReported>false</TuplesReported>
  <UnitCount>5</UnitCount>
  <MyReports>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R1.htm</HtmlFileName>
      <LongName>101 - Document - Document and Entity Information</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DocumentandEntityInformation</Role>
      <ShortName>Document and Entity Information</ShortName>
      <MenuCategory>Cover</MenuCategory>
      <Position>1</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R2.htm</HtmlFileName>
      <LongName>103 - Statement - Consolidated Balance Sheets</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassified</Role>
      <ShortName>Consolidated Balance Sheets</ShortName>
      <MenuCategory>Statements</MenuCategory>
      <Position>2</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R3.htm</HtmlFileName>
      <LongName>104 - Statement - Consolidated Balance Sheets (Parenthetical)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassifiedParenthetical</Role>
      <ShortName>Consolidated Balance Sheets (Parenthetical)</ShortName>
      <MenuCategory>Statements</MenuCategory>
      <Position>3</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R4.htm</HtmlFileName>
      <LongName>105 - Statement - Consolidated Statements of Income</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/StatementOfIncomeAlternative</Role>
      <ShortName>Consolidated Statements of Income</ShortName>
      <MenuCategory>Statements</MenuCategory>
      <Position>4</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R5.htm</HtmlFileName>
      <LongName>106 - Statement - Consolidated Statements of Equity</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/StatementOfShareholdersEquityAndOtherComprehensiveIncome</Role>
      <ShortName>Consolidated Statements of Equity</ShortName>
      <MenuCategory>Statements</MenuCategory>
      <Position>5</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R6.htm</HtmlFileName>
      <LongName>107 - Statement - Consolidated Statements of Cash Flows</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/StatementOfCashFlowsIndirect</Role>
      <ShortName>Consolidated Statements of Cash Flows</ShortName>
      <MenuCategory>Statements</MenuCategory>
      <Position>6</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R7.htm</HtmlFileName>
      <LongName>108 - Disclosure - General</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsNatureOfOperations</Role>
      <ShortName>General</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>7</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R8.htm</HtmlFileName>
      <LongName>109 - Disclosure - Summary of Significant Accounting Policies</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock</Role>
      <ShortName>Summary of Significant Accounting Policies</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>8</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R9.htm</HtmlFileName>
      <LongName>110 - Disclosure - Investments</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock</Role>
      <ShortName>Investments</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>9</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R10.htm</HtmlFileName>
      <LongName>111 - Disclosure - Accounts Receivable and Net Revenue</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock</Role>
      <ShortName>Accounts Receivable and Net Revenue</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>10</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R11.htm</HtmlFileName>
      <LongName>112 - Disclosure - Property and Equipment</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock</Role>
      <ShortName>Property and Equipment</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>11</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R12.htm</HtmlFileName>
      <LongName>113 - Disclosure - Business Acquisitions</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsBusinessCombinationDisclosureTextBlock</Role>
      <ShortName>Business Acquisitions</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>12</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R13.htm</HtmlFileName>
      <LongName>114 - Disclosure - Goodwill and Intangible Assets</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock</Role>
      <ShortName>Goodwill and Intangible Assets</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>13</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R14.htm</HtmlFileName>
      <LongName>115 - Disclosure - Accounts Payable and Accrued Expenses</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock</Role>
      <ShortName>Accounts Payable and Accrued Expenses</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>14</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R15.htm</HtmlFileName>
      <LongName>116 - Disclosure - Accrued Professional Liabilities</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock</Role>
      <ShortName>Accrued Professional Liabilities</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>15</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R16.htm</HtmlFileName>
      <LongName>117 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock</Role>
      <ShortName>Line of Credit, Long-Term Debt and Capital Lease Obligations</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>16</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R17.htm</HtmlFileName>
      <LongName>118 - Disclosure - Income Taxes</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlock</Role>
      <ShortName>Income Taxes</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>17</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R18.htm</HtmlFileName>
      <LongName>119 - Disclosure - Common and Common Equivalent Shares</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlock</Role>
      <ShortName>Common and Common Equivalent Shares</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>18</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R19.htm</HtmlFileName>
      <LongName>120 - Disclosure - Stock Incentive Plans and Stock Purchase Plans</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock</Role>
      <ShortName>Stock Incentive Plans and Stock Purchase Plans</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>19</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R20.htm</HtmlFileName>
      <LongName>121 - Disclosure - Common Stock Repurchase Programs</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommonStockRepurchasesTextBlock</Role>
      <ShortName>Common Stock Repurchase Programs</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>20</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R21.htm</HtmlFileName>
      <LongName>122 - Disclosure - Retirement Plans</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPensionAndOtherPostretirementBenefitsDisclosureTextBlock</Role>
      <ShortName>Retirement Plans</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>21</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R22.htm</HtmlFileName>
      <LongName>123 - Disclosure - Commitments and Contingencies</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock</Role>
      <ShortName>Commitments and Contingencies</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>22</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R23.htm</HtmlFileName>
      <LongName>124 - Disclosure - Selected Quarterly Financial Information</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock</Role>
      <ShortName>Selected Quarterly Financial Information</ShortName>
      <MenuCategory>Notes</MenuCategory>
      <Position>23</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R24.htm</HtmlFileName>
      <LongName>125 - Disclosure - Summary of Significant Accounting Policies (Policies)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockPolicies</Role>
      <ShortName>Summary of Significant Accounting Policies (Policies)</ShortName>
      <MenuCategory>Policies</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock</ParentRole>
      <Position>24</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R25.htm</HtmlFileName>
      <LongName>126 - Disclosure - Summary of Significant Accounting Policies (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlockTables</Role>
      <ShortName>Summary of Significant Accounting Policies (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsSignificantAccountingPoliciesTextBlock</ParentRole>
      <Position>25</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R26.htm</HtmlFileName>
      <LongName>127 - Disclosure - Investments (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlockTables</Role>
      <ShortName>Investments (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsInvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock</ParentRole>
      <Position>26</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R27.htm</HtmlFileName>
      <LongName>128 - Disclosure - Accounts Receivable and Net Revenue (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlockTables</Role>
      <ShortName>Accounts Receivable and Net Revenue (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsReceivableAndNetRevenueDisclosureTextBlock</ParentRole>
      <Position>27</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R28.htm</HtmlFileName>
      <LongName>129 - Disclosure - Property and Equipment (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlockTables</Role>
      <ShortName>Property and Equipment (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsPropertyPlantAndEquipmentDisclosureTextBlock</ParentRole>
      <Position>28</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R29.htm</HtmlFileName>
      <LongName>130 - Disclosure - Goodwill and Intangible Assets (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlockTables</Role>
      <ShortName>Goodwill and Intangible Assets (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsGoodwillAndIntangibleAssetsDisclosureTextBlock</ParentRole>
      <Position>29</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R30.htm</HtmlFileName>
      <LongName>131 - Disclosure - Accounts Payable and Accrued Expenses (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlockTables</Role>
      <ShortName>Accounts Payable and Accrued Expenses (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsAccountsPayableAndAccruedLiabilitiesDisclosureTextBlock</ParentRole>
      <Position>30</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R31.htm</HtmlFileName>
      <LongName>132 - Disclosure - Accrued Professional Liabilities (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlockTables</Role>
      <ShortName>Accrued Professional Liabilities (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsMalpracticeLossContingencyDisclosureTextBlock</ParentRole>
      <Position>31</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R32.htm</HtmlFileName>
      <LongName>133 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlockTables</Role>
      <ShortName>Line of Credit, Long-Term Debt and Capital Lease Obligations (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDebtAndCapitalLeasesDisclosuresTextBlock</ParentRole>
      <Position>32</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R33.htm</HtmlFileName>
      <LongName>134 - Disclosure - Income Taxes (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlockTables</Role>
      <ShortName>Income Taxes (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsIncomeTaxDisclosureTextBlock</ParentRole>
      <Position>33</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R34.htm</HtmlFileName>
      <LongName>135 - Disclosure - Common and Common Equivalent Shares (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlockTables</Role>
      <ShortName>Common and Common Equivalent Shares (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsEarningsPerShareTextBlock</ParentRole>
      <Position>34</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R35.htm</HtmlFileName>
      <LongName>136 - Disclosure - Stock Incentive Plans and Stock Purchase Plans (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlockTables</Role>
      <ShortName>Stock Incentive Plans and Stock Purchase Plans (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsDisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock</ParentRole>
      <Position>35</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R36.htm</HtmlFileName>
      <LongName>137 - Disclosure - Commitments and Contingencies (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlockTables</Role>
      <ShortName>Commitments and Contingencies (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsCommitmentsAndContingenciesDisclosureTextBlock</ParentRole>
      <Position>36</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R37.htm</HtmlFileName>
      <LongName>138 - Disclosure - Selected Quarterly Financial Information (Tables)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlockTables</Role>
      <ShortName>Selected Quarterly Financial Information (Tables)</ShortName>
      <MenuCategory>Tables</MenuCategory>
      <ParentRole>http://www.mednax.com/taxonomy/role/NotesToFinancialStatementsQuarterlyFinancialInformationTextBlock</ParentRole>
      <Position>37</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R38.htm</HtmlFileName>
      <LongName>139 - Disclosure - Summary of Significant Accounting Policies - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformation</Role>
      <ShortName>Summary of Significant Accounting Policies - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>38</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R39.htm</HtmlFileName>
      <LongName>140 - Disclosure - Summary of Significant Accounting Policies - Schedule of Net Revenue by Service Line (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesScheduleOfNetRevenueByServiceLine</Role>
      <ShortName>Summary of Significant Accounting Policies - Schedule of Net Revenue by Service Line (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>39</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R40.htm</HtmlFileName>
      <LongName>141 - Disclosure - Investments - Schedule of Investments (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfInvestments</Role>
      <ShortName>Investments - Schedule of Investments (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>40</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R41.htm</HtmlFileName>
      <LongName>142 - Disclosure - Investments - Schedule of Contractual Maturities of Long-Term Investments (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureInvestmentsScheduleOfContractualMaturitiesOfLongTermInvestments</Role>
      <ShortName>Investments - Schedule of Contractual Maturities of Long-Term Investments (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>41</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R42.htm</HtmlFileName>
      <LongName>143 - Disclosure - Accounts Receivable and Net Revenue - Schedule of Accounts Receivable, Net (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfAccountsReceivableNet</Role>
      <ShortName>Accounts Receivable and Net Revenue - Schedule of Accounts Receivable, Net (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>42</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R43.htm</HtmlFileName>
      <LongName>144 - Disclosure - Accounts Receivable and Net Revenue - Schedule of Net Revenue (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetRevenue</Role>
      <ShortName>Accounts Receivable and Net Revenue - Schedule of Net Revenue (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>43</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R44.htm</HtmlFileName>
      <LongName>145 - Disclosure - Accounts Receivable and Net Revenue - Schedule of Net Patient Service Revenue by Type of Payor (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueScheduleOfNetPatientServiceRevenueByTypeOfPayor</Role>
      <ShortName>Accounts Receivable and Net Revenue - Schedule of Net Patient Service Revenue by Type of Payor (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>44</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R45.htm</HtmlFileName>
      <LongName>146 - Disclosure - Accounts Receivable and Net Revenue - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureAccountsReceivableAndNetRevenueAdditionalInformation</Role>
      <ShortName>Accounts Receivable and Net Revenue - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>45</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R46.htm</HtmlFileName>
      <LongName>147 - Disclosure - Property Plant and Equipment - Schedule of Property and Equipment (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosurePropertyPlantAndEquipmentScheduleOfPropertyAndEquipment</Role>
      <ShortName>Property Plant and Equipment - Schedule of Property and Equipment (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>46</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R47.htm</HtmlFileName>
      <LongName>148 - Disclosure - Property and Equipment - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosurePropertyAndEquipmentAdditionalInformation</Role>
      <ShortName>Property and Equipment - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>47</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R48.htm</HtmlFileName>
      <LongName>149 - Disclosure - Business Acquisitions - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureBusinessAcquisitionsAdditionalInformation</Role>
      <ShortName>Business Acquisitions - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>48</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R49.htm</HtmlFileName>
      <LongName>150 - Disclosure - Goodwill and Intangible Assets - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAdditionalInformation</Role>
      <ShortName>Goodwill and Intangible Assets - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>49</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R50.htm</HtmlFileName>
      <LongName>151 - Disclosure - Goodwill and Intangible Assets - Summary of Intangible Assets, Net (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsSummaryOfIntangibleAssetsNet</Role>
      <ShortName>Goodwill and Intangible Assets - Summary of Intangible Assets, Net (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>50</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R51.htm</HtmlFileName>
      <LongName>152 - Disclosure - Goodwill and Intangible Assets - Amortization Expenses for Existing Intangible Assets for the Next Five Years (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureGoodwillAndIntangibleAssetsAmortizationExpensesForExistingIntangibleAssetsForTheNextFiveYears</Role>
      <ShortName>Goodwill and Intangible Assets - Amortization Expenses for Existing Intangible Assets for the Next Five Years (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>51</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R52.htm</HtmlFileName>
      <LongName>153 - Disclosure - Accounts Payable and Accrued Expenses - Schedule of Accounts Payable and Accrued Expenses (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureAccountsPayableAndAccruedExpensesScheduleOfAccountsPayableAndAccruedExpenses</Role>
      <ShortName>Accounts Payable and Accrued Expenses - Schedule of Accounts Payable and Accrued Expenses (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>52</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R53.htm</HtmlFileName>
      <LongName>154 - Disclosure - Accrued Professional Liabilities - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesAdditionalInformation</Role>
      <ShortName>Accrued Professional Liabilities - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>53</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R54.htm</HtmlFileName>
      <LongName>155 - Disclosure - Accrued Professional Liabilities - Schedule of Accrued Professional Liability (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureAccruedProfessionalLiabilitiesScheduleOfAccruedProfessionalLiability</Role>
      <ShortName>Accrued Professional Liabilities - Schedule of Accrued Professional Liability (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>54</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R55.htm</HtmlFileName>
      <LongName>156 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsAdditionalInformation</Role>
      <ShortName>Line of Credit, Long-Term Debt and Capital Lease Obligations - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>55</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R56.htm</HtmlFileName>
      <LongName>157 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Long-Term Debt (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfLongTermDebt</Role>
      <ShortName>Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Long-Term Debt (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>56</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R57.htm</HtmlFileName>
      <LongName>158 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations - Summary of Estimated Fair Value of Notes (Detail)</LongName>
      <ReportType>Notes</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsSummaryOfEstimatedFairValueOfNotes</Role>
      <ShortName>Line of Credit, Long-Term Debt and Capital Lease Obligations - Summary of Estimated Fair Value of Notes (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>57</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R58.htm</HtmlFileName>
      <LongName>159 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Capital Lease Obligations (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfCapitalLeaseObligations</Role>
      <ShortName>Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Capital Lease Obligations (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>58</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R59.htm</HtmlFileName>
      <LongName>160 - Disclosure - Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Amounts Due Under Terms of Capital Lease Obligations (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureLineOfCreditLongTermDebtAndCapitalLeaseObligationsScheduleOfAmountsDueUnderTermsOfCapitalLeaseObligations</Role>
      <ShortName>Line of Credit, Long-Term Debt and Capital Lease Obligations - Schedule of Amounts Due Under Terms of Capital Lease Obligations (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>59</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R60.htm</HtmlFileName>
      <LongName>161 - Disclosure - Income Taxes - Summary of Components of Income Tax Provision (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSummaryOfComponentsOfIncomeTaxProvision</Role>
      <ShortName>Income Taxes - Summary of Components of Income Tax Provision (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>60</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R61.htm</HtmlFileName>
      <LongName>162 - Disclosure - Income Taxes - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesAdditionalInformation</Role>
      <ShortName>Income Taxes - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>61</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R62.htm</HtmlFileName>
      <LongName>163 - Disclosure - Income Taxes - Schedule of Differences Between Effective Rate and United States Federal Income Tax Statutory Rate (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfDifferencesBetweenEffectiveRateAndUnitedStatesFederalIncomeTaxStatutoryRate</Role>
      <ShortName>Income Taxes - Schedule of Differences Between Effective Rate and United States Federal Income Tax Statutory Rate (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>62</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R63.htm</HtmlFileName>
      <LongName>164 - Disclosure - Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesSignificantComponentsOfDeferredIncomeTaxAssetsAndLiabilities</Role>
      <ShortName>Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>63</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R64.htm</HtmlFileName>
      <LongName>165 - Disclosure - Income Taxes - Schedule of Activity Related to Gross Unrecognized Tax Benefits (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureIncomeTaxesScheduleOfActivityRelatedToGrossUnrecognizedTaxBenefits</Role>
      <ShortName>Income Taxes - Schedule of Activity Related to Gross Unrecognized Tax Benefits (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>64</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R65.htm</HtmlFileName>
      <LongName>166 - Disclosure - Common and Common Equivalent Shares - Schedule of Calculation of Shares Used in Basic and Diluted Net Income Per Share (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureCommonAndCommonEquivalentSharesScheduleOfCalculationOfSharesUsedInBasicAndDilutedNetIncomePerShare</Role>
      <ShortName>Common and Common Equivalent Shares - Schedule of Calculation of Shares Used in Basic and Diluted Net Income Per Share (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>65</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R66.htm</HtmlFileName>
      <LongName>167 - Disclosure - Stock Incentive Plans and Stock Purchase Plans - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansAdditionalInformation</Role>
      <ShortName>Stock Incentive Plans and Stock Purchase Plans - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>66</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R67.htm</HtmlFileName>
      <LongName>168 - Disclosure - Stock Incentive Plans and Stock Purchase Plans - Schedule of Restricted Stock and Deferred Stock Awards (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfRestrictedStockAndDeferredStockAwards</Role>
      <ShortName>Stock Incentive Plans and Stock Purchase Plans - Schedule of Restricted Stock and Deferred Stock Awards (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>67</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R68.htm</HtmlFileName>
      <LongName>169 - Disclosure - Stock Incentive Plans and Stock Purchase Plans - Schedule of Activity and Certain Other Information Related to Stock Option Awards (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureStockIncentivePlansAndStockPurchasePlansScheduleOfActivityAndCertainOtherInformationRelatedToStockOptionAwards</Role>
      <ShortName>Stock Incentive Plans and Stock Purchase Plans - Schedule of Activity and Certain Other Information Related to Stock Option Awards (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>68</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R69.htm</HtmlFileName>
      <LongName>170 - Disclosure - Common Stock Repurchase Programs - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureCommonStockRepurchaseProgramsAdditionalInformation</Role>
      <ShortName>Common Stock Repurchase Programs - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>69</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R70.htm</HtmlFileName>
      <LongName>171 - Disclosure - Retirement Plans - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureRetirementPlansAdditionalInformation</Role>
      <ShortName>Retirement Plans - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>70</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R71.htm</HtmlFileName>
      <LongName>172 - Disclosure - Commitments and Contingencies - Additional Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesAdditionalInformation</Role>
      <ShortName>Commitments and Contingencies - Additional Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>71</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R72.htm</HtmlFileName>
      <LongName>173 - Disclosure - Commitments and Contingencies - Schedule of Future Minimum Lease Payments under Non-Cancelable Operating Leases (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumLeasePaymentsUnderNonCancelableOperatingLeases</Role>
      <ShortName>Commitments and Contingencies - Schedule of Future Minimum Lease Payments under Non-Cancelable Operating Leases (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>72</Position>
    </Report>
    <Report instance="md-20181231.xml">
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <HtmlFileName>R73.htm</HtmlFileName>
      <LongName>174 - Disclosure - Selected Quarterly Financial Information - Summary of Company's Selected Quarterly Financial Information (Detail)</LongName>
      <ReportType>Sheet</ReportType>
      <Role>http://www.mednax.com/taxonomy/role/DisclosureSelectedQuarterlyFinancialInformationSummaryOfCompanysSelectedQuarterlyFinancialInformation</Role>
      <ShortName>Selected Quarterly Financial Information - Summary of Company's Selected Quarterly Financial Information (Detail)</ShortName>
      <MenuCategory>Details</MenuCategory>
      <Position>73</Position>
    </Report>
    <Report>
      <IsDefault>false</IsDefault>
      <HasEmbeddedReports>false</HasEmbeddedReports>
      <LongName>All Reports</LongName>
      <ReportType>Book</ReportType>
      <ShortName>All Reports</ShortName>
    </Report>
  </MyReports>
  <InputFiles>
    <File>md-20181231.xml</File>
    <File>md-20181231.xsd</File>
    <File>md-20181231_cal.xml</File>
    <File>md-20181231_def.xml</File>
    <File>md-20181231_lab.xml</File>
    <File>md-20181231_pre.xml</File>
  </InputFiles>
  <SupplementalFiles/>
  <BaseTaxonomies>
    <BaseTaxonomy>http://xbrl.sec.gov/invest/2013-01-31</BaseTaxonomy>
    <BaseTaxonomy>http://fasb.org/us-gaap/2018-01-31</BaseTaxonomy>
    <BaseTaxonomy>http://xbrl.sec.gov/dei/2018-01-31</BaseTaxonomy>
    <BaseTaxonomy>http://fasb.org/srt/2018-01-31</BaseTaxonomy>
  </BaseTaxonomies>
  <HasPresentationLinkbase>true</HasPresentationLinkbase>
  <HasCalculationLinkbase>true</HasCalculationLinkbase>
</FilingSummary>
</XML>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>ZIP
<SEQUENCE>97
<FILENAME>0001193125-19-040891-xbrl.zip
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
begin 644 0001193125-19-040891-xbrl.zip
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MWP@#^@ ]HFO'-PL.X[_MA1QXL@R,0B17=W20+9HKV1:\0[,H<0 /IFG8)=F
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MC$*1CKU_2OI>)&.:AB(S1Y=LU\-J"P?/T0PB:8KO&;9'#5?-#=[EDJ).P.Q
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M94T#/%M"5"(QZBH@CPQ3TG7/,G57,6W-%END+)>!'ATSQ]N(7&/LT]7]U!N
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M9WL8F[/)D[)MQ<(33HL\4VQ^-1]C^ P-RTI^"5S[*4ZCEW >/--W/>)+NJV
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M5<\4NEM2:0-Y)T)(HZ>PX&BN^D:B2O_M=(CCM4;V//L09__"IIG1]OTQ3L*
M!O: 4_0:&KM"M)$:TT_Q.!H^'TYYV=A1V?")9/BN@PT"P73Q5. L33,4W]9=
M&P<X7,H>]RM[/&[MRQ[%3E6_C>=S%S0WJ-28B].)1;KWI7)Q^\K%WE/ S6,X
MR.<HX>F4L'#NXV00C,>#NX(J@@I5#()L<!]$"88"YB$\ G/^RAK'H#8$%RR-
M09!BM2,\/0EAW4+Z70^LZ3/<"CH!5,1])&HFA841% .B\+F5/"C\'2?2\@<M
M1OSF"YB$ 7K?(UP=O Z6!WB8@8,)/D1EN>D UH7%EY5UPA-&X(E=#][>PP+O
M$3U\^<%=/$=0AYG(:QQ&R7 ^P<G=0WA.^!2EJ-T0OOC^YY^:3^7/'$0IP@SX
M'8?PEUC; )1!40.:A#,T4Z8/\( 9-U+A^L&WQVCX. A:\3^(AX##](K?7NS<
MMV@\AB>(IV$FF9A;&8P'P62QI7@'V,03\9=XB5@UWW>QBMJ*KSE]Y+A%'5\L
M$D! 5 [#ZC+X"H8A8#P=I/-[,38WJ^$TBP?WH-/&L'.B!G:Q,TB-C_&W\&N8
M".#R5R%L0+098'P8P@8#AP^>L<O!/3B"*_?20GI>^ _XXC:T9(^P)YPR<TKD
M!#7BK1;XLUM@K],?[M>FG>2++!=3OAP?- (L)Q/8Y='U1<@N%*WR?4G9MSQP
M-T5Q!$SP+<H>!\,PR0*@D*IHK3,U+\)";LQB%'(/21@N:#E \BX\XI*BX'G#
M('T<\,;XDPF\*\4N(@/N(,-#2N'W& &?<6($050L!<B6<RJR=4[W0E3,9X)Q
MOZ*X1]Y+40!PX7</:VP5?>EU3;>4S\L>HQ2>LBHIKZY="HFY)%=!'@MI$R<C
M%#; 9*N?")Q6*I)GQ U&!_#3-!?;^2+SV#'8S>9OZ0!]%CR*Q"#=P [&'"U?
M'D/446N4R$U-JB%ZPV#=ZA8+XWA!4;/09/S64K(L)"+0#R)UR!TNW/6:0JX(
MIR"7YB$'.P^2XOUP3SS+UY#F,@QNW8R)+QG\(^@08!.]PJ\'7\)P /Y,.-"0
M8.!!X'V'-<F?HZSU!:UV1ET>K@O0KW:8NKCYB[VX 5<VO0_10#FQKP[_<0EQ
M+,G@L5(3/#'3E V)RK:A>:ZK>QK-A^X2THQT; /61H0<M=D.E7W?TS53(C+<
MQU1'ERRJPG\\4W=]8BBFJER\SA^GV8[6N=E.JW]Z::WS [36<1>V.+?ZP?
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M^JVG-,%T"I0_S#FZB#GF?"7<"QY-PL27.,-0)0\;C3 LF:TFP464K1KGR#^
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MET(O#H,D>49.*B.MPOJIO;AQU!V6<0JA9(5+$ P>T!K!Y&/4[;A6/#<N5%/
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M&MVU=+Q*$#45"? +^G!^\_%2T7?A?>7"Q27N;YAB$'];1NJR!.PDS;H(P,5
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M]< "KD=\H?X+IIE8SK!4E%P]XU<E7 M5S%<)FBH-AB+"^AB O+\+PRG<""S
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M&^5;_99;Q^>Q>P0 QHQTK;9]W0!J1T(OH->8\?^S]^4_;B/'PK\OX/^!,+S
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MAM[,I69.22,'HTMI## \TPC?CV!2TYT=(CLL+7A<;NE;F42G<5"COD#1I53
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M #L\OPGZ9!(1(B4>*0(L3.#?;C2<S,$<&A'L!42C]CE^98A'),& <H !81Q
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MF/DYF<='-V@8>YG5!GK>3W$>!G- "!HA"4'3#2T*>!&<NJZ/-YKTV,3MNO&
MQ<\W[V*4;*=E/',HM_9 OF01@II"!2%O4"NXSA:$80TW ;MB7#K_ ;4P]<$,
M<)^ 00^PMSUX!V@'-.G(>,R I"L!_P[:@GP<6&,F\-RNGI6;I6;1V&'3M6@X
MB0U62J<81_F3L,B,BSL>E2>+JHR6=L+&0-E>RI9^MW"#T$YXQA%:4?<X"8S/
M >-SP/@<L'/- ;/U$^> [1CJM78S>ZEA7-M?K3?XU7RDU4'CG11YYWRG_]#
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M'\<IIN74P$-"(\Y4C15?\3E<MJ/^U?7);ZB8P<0#BG9#WV=Z*/XTKGSP 'P
M1;,4>2LQ]L1N,WG0O?Z!LXQ!S69B1=><N!&AJJ9;W-87#9N9 R"$;AJ2YJ@=
ML'0'EM36];ZDJ?V.9JL=R];1T@7Z:-9JV.P8[/;9.E])X(71AS!XO(=SI$<>
M*AIM =_:D+/_>VX+K>.TG1(?T!6'70?.MU=1U#'@;ZF:L0/W$A:[U0;\+ ]
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MDRTVSPJ/XES"_EA(V#B7,'CE4K[P)*+#L1;9_2F>@=ECS]<X+0K2L!I@60N
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M\1MNJ)9 _5[S)GH'(+=KJW/TV+?PC/CWC5.A*DYMH,JW=B/-X4 7RR--07V
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MI=3%C:I6&/R%3WV)DS^HMB)7].'?),7YI'ZRTI4=AZAF)@F\EVI7Q59P:"N
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MT8.W.W%1!'9BKH48;=3Z.0J"%H(6K:-%R\VD+B@7FGJ>T4MM$< "/Z%BB/%
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M/C6MZ!)0&X* ;8$J*CT$%B-0U9@BQ"8YV P1UKD)0FP[.EOZR>UV;\I5#'<
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M S8'.$?C($]YC(:&7Q(?W74*G0FS(MDRGE,G'BLX*%.)\Y0L<IRP=T?2JFJ
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MI:TG'GZ6(\8O;<'S*Z8J:>M,HMVS7^]0 ^X)7 OX0%.W#WZQK32X>K\\VPK
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MF07XQC@Z#-JU&V5HLN[UXDIU_@)U,QGPC>EVX;*<[FW?7F%W*RJM3E<U\]E
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MB)3ZH9\$\ J,K]Z0B"R"K'O#;RU'EXUV]Z(Y&45;DTVMU5V$3D;1M673.7I
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M4;W19US]%]T!10G^]_Q4:>[/R]"H2'L:L*PG>G''?D;.1+;/(%0^[UXK?9>
MGN4.S-'85.S)>*R8WL!5/-L=*X8S</2A:XY'8YU=*MNXLISGI]XW=VZ+H*7L
M^DAN<?D/9!TG.*^F)KD -/;'4GH=O_W;&SJU!KJC>KIB:5/84'7L*)YE6XJA
MN[;CN):F3FUV(U#X<MG[3)I0'ZP>\_MSZ]@G&%6%6OL)U36P-.(O</ D;N?D
MJQ4\\A<0![4YO#5^M.'F$9PH[Z=4BD@F)>2.1, 0;C:P4$J2NV!&I#"(B/0F
MB%!;G,'!A9N0[ND5),SF5EAI3W""A-G\(F:S6S-N\9Z1Y%XCNFGH\N<=Z_M'
MATS*9^Y_Y*D^O^_5=H]?_8CHEWON(/]3!18??I8CQB]MP?,;;;DSUI;[]0XU
MX)[ M8C08;1]\&LON<&?_T/\)*U F41S,J]^'9,96=V0I/K$T&0*[LV1,41!
MT=,HJN\C:$E-U&&?ECQ'/?$\F#H7@ZG][%?NTLH7#NS_^3N)(S\#I&XWU,4<
MH[4+:OP\\+,DF(%9<).N";I6LZ"# P*-H[/'O^]"<HYQ=.NH;J!W=-[1@^A=
M?(+E@3QB$)$4V$(:4#;1/1YP].2X;ER2H\=R= .]7O" 'FH.'_QY1QG"\2G)
MG;@Q_>8'YU'HA$IPV.7_S0?K+O)#94$R/Y168"_,@NCYYW2)NR*PZS0GZ*%B
M\)L?^2S&7L0'N^<WZ+?;H-_8G<?<$QK"H8.%"A?BS$^Z:BD<79W9B8LBL#L/
M&^A!T:*8XOS$I[DM^+89-D&+]L#VK9UMN9G4!>5"4X]NP-8) 2SP$RJ&J#;N
MB& 3U!#4:"4U3BX2/:C0YMYJG;WE1!\S>(27!0UF67 79)MFV>G3%>X,O)$[
M=>R!,E$'0\5TAB-EX*JZ8AI3S1P--<^BE5"B<.>$PIW6=RO PAV?'S0VKYLD
MF1]$/&TOJ(ZVE)#0QV+P+.8EW7LK>N(\2S-8".N 4CS-4DR/L^1C+5R*I>2T
M' CKNB6"*=6PTMY<:@D/+ZU#]U->7+2G7[JH !*-,T0%T D50)Y^6@60I1U>
M >2^7!G."Q8?O2#69W^U*%5YPK*&W_.F,(P7%)*;\DN)]/<:4/1SJCE6CW =
MLOG<V;T>+[YS1?'\M_>+E]=_^XN3KR29!>DCOGF=!#-RR3M>VY3:]M8^_4!6
MH%N" -KZ? 2Z1P)J:.Z'6W_Y1)+5MW<>"\51H4Q_N+3M']S>)@1TN>V=?@L;
MBCQS]NW-^Q<VE7C4'F_]:16$(3*9)][TE@<"GLD"/B53XGW-!O,SZ7_]*/>3
M3;7GW+8ZRLWSDO$-W;1EPWR9]L\'/WOD3%'=N;)>IOWSX<^^U/=:#?/%IW4=
M.""OT*^ZUV[_C688LF$?G?OX0U<8TO$%88(AG8LJ5V>AR85$BD72C;B#'8>Y
M+2>LS; )2_-9+<UH+A&FS-%P#5B>]\?U.J?L:9HN>\Y91D>V1ZEPKNRC:UV>
M6<R<2LZKEYF3]5RD5*^.;N0B]$.1+26TK9:2J]7 /?]9:@WJK0;N,*Y^3$;D
MD<F,^Y,CT_>+41QAM(MEMKQ?? C2/X8;_/?4GV5Q<H9L2&MHNA-K.%$,PQLK
MIFUYRM"V5&4PL$:>9MJJ/1V(;,CM'#265=>O=,BJCWF02CYO8[[!239QGDAK
M?Q,GTBKX*H.Q@]-OX-!C@J(/3U>]RO';M=[F^-U9F*?!'?V+/U_!>U-ZO.&3
M!0'"@_4$*Q2]T&NYEJO=Y@=57T6YS*?D WE@C0#,L1D^+9(E1;*D2)84[=*_
M_?E]KQ;MTD7&HFB7WE.*BG;IHEVZR-5[Z0A*D?H*RC[3].?8WJA[?0^=?I?F
M"_2.0>_B<^$.9 :_QG<DB=#6[]S]U\U>7Q"]WRW?]9?K;2;4@P<3+&@9=K8,
MDKFR]I-.CDSI-V?H-W:B.7H;N #"AR[G L0M/WNYZ==)<.=G!#@%ZXR*SS1/
MP=H'%A)EW6,B_9ZP<'3%SP5C=R&Y2");]XE/<UOP;3-L@A;M@>U;.]MR(ZL+
MRH5H+"KPNV 50Z1"MDFP"6H(:K22&B>F"1^0UKN5%[S5;_4:-*O9AOW[#)G
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MNZ7T=3E_@S_386I2N1D2W0TJ/F]*>^&)ZCT?!,[>"1R8WQ? ?JIJ#Z5;RC$
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M]TE6/%S4\ ><7/,@G84QMK[!K\X*$R*K/=5\)GO%.N305C;P"/Z\=QOQR7M
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M=G00WM.PN_Y9YH"T"$O'5F7-.XL#7 3A#^,-_XC3=9#Y81E_E_SY"FP6,("
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M:]CVP'/M/G5]X6OL N=R,]<W.P&XC).<AP'''DX*!F)@_$OBP(J_)7%Z-NC
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M(3&H-60N.A9=F^M8$@ZXF,.RL+CE5?\>);,NRG"!+R,)!$\UE.4^]CO#Y2[
MI2J(L0<=J4+4=2V@/!__)D!%AQD<4V]=T3<-ZO#!L,?8@/7@Q1KV94M^)R!W
M]U[#(P=W=W*48<[@X<8#%A024?M,#5[,U"#839J4_(!'@KN$S,DD'N&\DO47
MYV,0:L35&JZR^GW+L7W?,'T!N'(%,SPJ7*/O4N:[ VM(7$=S%5MIN5T-GA(.
MHBP<AY,I3HB]E2,,FX0R'?S$K%(YUEFGCT_3+-"5GX,@B4#J(*^JE^B"[".@
MJ)HU8?5=[MA4&*[J/FW9ON'W1=\0V N@;_9<GW+ #M-[;@$SQX"RO7&DIK>H
MZ:QEOT;C1D"3) O_E5-L&$9!A+-4L1T_3BSIA^GNXV\.QZ/@3J_/!PP48I\:
MG/NNX=-ASQARYEI]T7-\"UN-<1!Q#A'+Z*L(T"8VW(AST"CQHZP@'3_*8^SD
M'82=Z_B]X:#O&9YI#PSN<6IX?<<Q>GW?[EFDYW/A:V''RSKTR'!OXZUR#6ZS
M.$*Q3VV;&3V/]]#,\ W/)3W#<ZRAQ1W0"YA+C3@2)BLC:2L<I6:_&FE*28RU
MBP(0.,5Y0/XTGW"!Z&WG?G+PN& OQ[&K0K06#Q_0]OKT30WB!NS-[FPG^'!L
MAA>YZ\#?!$@9ZO0!_Q^3-+\'$Y3A<_\5_@ 2:/F+A2O7&ZZSRA10LP]8G8<5
M_'HKMA*)Z-WCA(H2$IO$2XDF2"=,1U)-85".:0,N/R\TBT33&9*^S_H&\4QB
M<(>##<:&8'FYW'+(<&!Z7G[:(4+8UG)\YP5(UH)]"\:8!.Q^ )/V3(#'@PMU
MQ3K0MT-3;@6BQ[#EZ)JKL?9C */KEE5"035XUN.@%<!7%"#8$!!]1&N!WPGJ
M)6YI!0HJTA_L6FI9;"T&J@!51L=3 JNJVV.Q[A3N^?9 6$-#^ 2K'DS?<&VW
M9Q"PO&P!EU$[[QBL')0E>.>KW@P/_#V1JG0]&B^::<V2=6CV3#J  W1OB /4
MW*%C>$,V-(8#/K![/0?.VR; :;UYY[A4\(UP;H)FA;W#"$WO"/3EMZEJ]38)
MU 2U^>RTAD\@;F\()]Z!X0^ N3FUB.'W=?V\R<1@P/N>R$\@5OD(4@F<TN ]
MI>;#[W+&_ZC\\0EA- 63(,_4C7=K)+ !#>5$:KZF&R*UX%AAH]=6P.'"MJCA
M,Q/^ZIL6.DNM@<NT6,>),\X"\-4A*6&@Y%KIHU?FV%3_"B__NNI16I-N7'$#
M$/?-._:6+TSPV@!'%7(C<T28=*Y;5Q1F$<K':18GSTL7U\ ':Q/J;=/KF3W2
M!T[PN,$MTS$<G_L&/'4P\,S!L(_CTO+90Y;Y(B?L!.3N6.LIRWG-D&#T%.E7
M%H. F]E)%?&7-XSCSF[XVP'<W7'Y*7N0R>RKZ/Y])A_3/?K#U(Z\O)1C<5#:
MH?#MCJWU9LQN^0:U8TJWP:0NWPU3FV K8>GG2*;I/'"UV;$V<V)Z^&;E<V^E
MY<[4R:V4A'$0F-N5'C8X'+5=Y:&/_ZU%-ZL\!<7N&^AC'(WE> J7?9O(X\78
MCK=Y:"ZCV6Z;9QU<>PKC/4< UXX9K&-!N4+('A)XX]C?[7Z!FHSCXY]]L;VU
M R;S\BEI=^!*DX#A0K@?SU7CQS *4S6A[OL1-\[QCXM@Y#";6O9R#/8%2);!
MUOC"1)^B\5$93;Z\BQ.YH*0&/^&!<3(&80SF)>IXV)&(GB2>*+5?-$!N(\H(
M<(]%F.TN>X]J1,,V?*,/.WO^368/Z+Z>E56V$W.8"D$<:PO>-H"S#@,G=K-5
MA9FI*B9:*MRLY%1;#4=\"(-OJ@1Z&">]21 ^8K@Y_V,FL_-'?I:I3+XW+'8J
M6G$$S@<&TWZ:):0<#N]+*+Q)Y%,0CHOC67XS/%9KOKK#Q@?@#.M,G!4VV@.\
M#;M)IAABK3>SX(# *8Z:LBU7K/!,:?4O,8 WTLD9^0 Y5'*C43*5XX+9VGKT
M0<5#X$WV"RQ0!< *2,([EK"KY^VU$C-H[5+*^,N860_52^A0FP>5LPX1MEE*
M$)V%SE:T;!60JNX=.#/(\'MK^<%=E_-6!9HR_-K^:K,!#Z *9KIEH;BT\$K<
M/>\\TG8QB'46-C<K,?@ZJ-:@ \V(8)(WFE:>&2_3D2+DBB_QW)E4]*F>=[$^
M!I:.FE(+$D X:Y3$04"NWQFM-A@8YMEQJVPQ+:V\#%9QXM JHG'0*FYZ1S<-
M*@&VLO92JRC<%BH'*BI2[9K.F!\,6-\?4L>P"2:1#HAM^);P#9?Y?L\!6H$*
MSS/FG;+X7KO\90A_"R9/V'0Y'*GSI#Z#W\MH]*R/#$4^7>-D94,NL%&^(43?
M,S@;4,,9"L?H<;=G"<M333@9MN$DC-C+*3D[ +6,#=#M<2']-$NT68\IN\6R
M'6<Y'6TC$/M1'LY'.S?%:HS\<":VQ7[$+^#:&RMP<Z(?T;#2KX@;3-C249_]
ML+, 7VF7R Q306^2^'LXEF/_^?<4;]#2M/WA,(J.%(<26CH55@>K$CK.)CIH
MH^H@P#A5L/%B,'##?3.CLN78(( -SIEM.U6PL0:J%6S,G;7M5"(@)ACEY9Y1
M2PO? M.R.7Q.(0GE3B4K9-X-M%)1<N$? %8YH?E0D=6Q&0%(P24$;(1@I?I:
M\WW^:SM96V#5#"&\%*E;6?P&V%J^<8%\EDW*I]8UJR\U3-#G5*QAU/,83Q8!
MJZJN5>V76S+QMX'Q L"*QS>V;V\G#G!XSDJ*\HZ0K4?+,$[F71>6!H>U$A/8
M,400ASIK,;$9F!=XPI^F880#AE)L*'RG2I_R<:6M1 -F[-H")]INYX@M<*W%
M",8,BR,!IF^DX3@/Q<_#BN=BUV*UCFES<QV&]H-S7Y2=C?&+\4*3V7MB[$5K
M&$332,JQREK /C^8T'L&(@?+?N#ZTE9["9;-H-\&$UGT\,;8/)B4F&,&.,4J
MYI9K8Z+:EU!K(S(J0K<>/:BO-B6FKO15:-81*X: ""XL Q0QF&6#H6UXG \,
M1@<^<ZAO.YSH2 *W2W[8O:#;S#_8WS\M&ORWDTO0+>OFX<0-?+($17D*XE.N
MR#[=G0&PV#?1(BO ;H3B&!W,FCLG<^4?*%>];FI5M@1T/KI@0ZE^*XF)#40I
M85LHN1VH1L=Y-L8$.@F1$>O(PSO;T+ZK(F-8Z_(C*O7R7'O-ZDCGI2@R=E/5
M>9WOHS1+IIKY\'CWY2&(/CTI7OL'Z-)Y'.-+#.PX#,*D[OY*ZPJ*3<<<4HL9
MG@.(Y)3:AF^;?<,S>]Z@+_H#T^WES>)<IQ(.Z\9/4S3Z&SPB2XLU_+<,[Q]@
M3=YWL)3OI?H11]/41+;J53-NSQ>>9;K&P.N;!O=\ G*@[P(]B67WO%[?]O,H
ML[!79\2W 7-'(FC^\L%/F8S"5*9+W/,>2Z'AY#,ZP18S_4$?A#$W:,]Q#-[W
M0%(S.C1<'R0U&?;L_C!O)B6.ML-V0$:Y8>G+S1#.IO+%0I3R<K?2_0"LL:]K
MXXTLR3I/W!$GVK3!.-BQ<>!:3\&AS< W]%,MLO:P8]-T@FX7=9:463;1Z6=H
MBL'U:']-LX<X.87?:> .^P,R-&R?@FTU&%##'Q /M(QO#?LFJA575U19@B\[
MMX\*=26$%NF0RX]>2(. :V_B-#S%X:4:'F%',I-40>-.L%;"WF==' J7+SWR
M0_"$GGCOZ6D2CC"2JELD2#P2/X;924Z"U9!IH0NCE%M4 ^S+R"V9.1^GC]]D
M\NDN;[^A,U _3;,T"R(\6#661EOQG(AQ*I<1<UE9[@A4)8RLW'6LHO/CX@-V
MI$MY22'L!-(!HBMOSG8FP@N[&M-29[WC@'N .CTGZ:]CQ/;^6G2K^'\<_U5E
M/Z5X=)C5$0[C!'V ^* )MN;^$JN'[-J6O[&<2%7T9/'<:-T9I@54Z!S*VRD*
M=YD6Q8+GD1B#];7$X43,L5 1G!D"-N>1SC ZPV,K.0%#G;!99L-'=@%HMQV1
MRZ76[@FJ\C_S421[ +6Z*8))D&@N*@1.*[<!55/NB=+.I7VP"L$<RMGP[$]W
M'['%,APPHBQO[9Y[Q/WG+\]/\/M-\!P?@^CE'B=K9V<ST>..9S#!B0&'*6K@
MN%G#[UF^3SR'*8Y0;/^V@'972$J=;.,(;]>>C<]A^L?\>61?F+^JX4/$UK-+
M3)9_=M1GRJU=^[Y9-O= 50K#LZTAG-\]T_!XSS58;V /',_F_0']2M1LT (Q
M5< [/2)PU+A-B8F?8?>R'9FE"EHHHD5W=+/.#RWPP3:W\<N^:&&(%MU$29PA
M6BQF6KP&M'!$B^Z?Z)XI6NK@%@O10LX:+:(&M A$"U.;R#D_M#!BFZ(.D6LC
M6G0?2+8+6IHT2Q -A'&%)F+OO&FJF"EDMFDH.\12.1%:'),[=@UHH?--0\X1
M+<3DN\J22D;MDD(^-[10AP!>:D#+7"';1S'W&\QE6C1NB<7V'$5J\O[0-7N^
M05#8<M<7AF,.A='K#0>$FJY+F#<3-=06)BFU!#DXO>E$*"N=!XZ-LD(,8<ZC
M0RX 8]05EBUJQ%@AH:A-'$<<%V-';NR'6'%LQ@$KPA&D"E;6Y4KWG'Z_+X@!
MYB,8.WX?C!W'I@8H )>Z R:&KHU;CZ* LMW5KD,O-_H[\:C0Q6G)S'+JG)RK
M!#ER38.C0ULZ_?$46&_#-,C=4TC^EAR04'X2-&.+*NO Q!D%=4,Y5B>1 %C3
M1DU[#9Z.DW,U'_:FKE)9@,,XN9-ZP. YX<IT9[/ECP#YJ=+63H(YG<96:H]R
M:!K;AOMUUD/-0LP2)MTYQZ,JTLA7I1VP'M^L),!>!+DUPK^$MQHXCJ"'5 G_
M<Y7]3>$(97\Y"?D8<E]SXQ;QMW\)?,-;$+L]EUH7[@_SP<+K3)!F6EBPN@/6
M#I#U39D8C8DM%^OE+\C": QQ_'!Y7UW4:[X]D_V('<M=+BH+>@W<L4N*%X"V
M!?Q9+U-87U7)$EO3D6M3G?%Q0<2YMO6"R+_:.8AKFJUM K()^Z4QV-%^X:Y=
M*O/8T88Y[HQ9U_RJCCEL_U0S"I!ZOM\S!FS(<<*J;_C,<XTA(5Z/^(P#O%^)
MGAPL2F3??<3LP>-%*T!<O6BT(NQ$!;2MG:>+'C95[B20\I<@79/2?[016,UQ
M,]-M@DH=0\]O E9S&$/AY[BB5-YPKO.OFL,;MCES5_KR-S[\JD%&P6QL[HIU
M,+\X^FK/T1O-08>=<FQ[9835ULD;!XP7: XPU8Q3E,!Z8;C $9K--\B7)GK3
M!;.775 5>\WOV0:Y0?! I5E<N,NG^2U-D \H]&D.*NR.3UU++(<NZ^Q_VQQL
MF*]OBG*SPA?;W]::8-(<]+ ;'699)=5X<#));>7'FS!3S8-2=1/;JOJ8+SLS
MVUA]W PZ!!8?L]+NWZ/XN)YZQ^8VB\J\LMT#JAV/4MG6H#9#:X2R?&ILE;JV
M.OTKSB$06T.;BQX=&+Q/>P9W!GW#<UW/&#I#:IG#/MC*+/>O"#!/VN%?V0IQ
M=:]#1=A1[)EOA7,*_TK#D(J7(*W?O]($-RO_BF.7#A3GZE]I F/*OV+SU1%^
M9^Q?:0)O&,"TZ.FGBS?(*6@-<--:-XF^7@=+$]"A@\5U5P;9UNM@:0(P;"C-
M2_,OFO.P-,*8VL-2COTVX6%I!#QLH\@XW3)PJ;$Q4PU"C1&AX\V7.O2TU03(
MEG+9<\H;=CHU 9MR.G'.V&Y.IWV2%1KD4;;$HYL[N]?N.6L"6A.S*(ECG9?G
M;!4S%<=?5V0!%SUGY?3E]GK.ZD:'@YXSQZK4QO!4GK,F-@L&(TUAK?J13N$Y
M:T06HI%"'%:](U1-GC.B?86"F;7Z"JG.3+)+)X93>,Y>AOC(^3HTSTP236<F
MG0)2_A*DM7K.&N-FG9D$[SUWSUEC&%,EA6#34G89KK/&$.?B6(!U7J2&/6?-
M<0I8 ]RTUWH+:_.<-08=>LX<JSG/66. X7AW40:K <=9<WRI'&<V+_4BJ=EQ
MUAQX#&U2X59VG!URLF@,*I6:!'JGP=2DQF!#+Q$EKKG! W::U*3&H,?4)$[=
M4IU'BQTL&S!SQ%P<JE.3J$,J#0(XK8.E$72HU"12DMCM<; TMEF4@\6QZ:D=
M+,UI,QSU0SAQ6N%@<0Z!N))+23M8A%4J:SR9@V4KQ$=.V*%Y:I)CG<+!TC"D
MXB5(ZW>P-,'-RL%BNZ9S$0Z6)C"F'2RNQ<K)"^?L8&D"<9B;1*T6%'\UQRK*
M'""T7!]5OX>E">@<G*PMS/(VJ-?#T@1@MFK*5B9:4RZ61AA3N5A<PJW&72R-
M@*=R5GCI=':BW*3FH&Y-;E)C(".=X;3%W(:]3DW IKQ.CK WP';4W*3F>+0-
MN4F-08NY2<1R2V?%MKO.5C%SQ&0<6N0FT?;/%&T&'2HWR2U5.K3,==;$9D%;
MF3AY*N:I76>-R,(W[P0U51QH1]?90K/JV0 _D!(H11[B"?+%,)XY*?;M*K>$
M")R= ^"KV3FN!3R[5QMYEXF^V>-] _8_-[@P7<.A0\N@U!_Z#%[ ^GD;>1P>
M:VUNT;TKU*4V7&H786MON.%D>%N5(FLGWE7'&<66!ZZYD!.T#Z"U.FFI=DN[
M-;NEF<Z"(T2<W$G[,L1'S@UC>1:<31IVTIX"4OX2I+4Z:1OC9N6DU7T0SMM)
MVQC&M)/6=MUM"5UGY*1M#''89)^6LCA.XJ1MCE4P#8X2TF@!:6/0J32X<I5>
MC4[:Q@"S0<.O9/<UX*-MCB^5C]8I%Z?5[*-M#CQ,@[,<QZSJHSWD$-L85.B0
MA!])@P[)QF!3#DG!&=W-(5FO+Z\QZ#$-3CAPACL77]X&S!PQ[XL5:7#5\KY.
MZ\MK!!TJ#<YRVEIGV-AFP9X<+L^[V9W0E]><-GOSSG($MU=[DC6<!D>U\^D
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M7=USVSB2?]^J_1]X?KG9JI%EV9-DXDIFR['C66_Y:RUG:N]>IF 2DG!#@5J
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MK\B,R =%G[V"HB8_CPXFHZ-)D;.6IYXZDJ,Y(:LJ1_*BD:M!N?1-/=_2*S3
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M2X-W&*=B4P$5[N<'X2O^PX.#HQC>I?9+M$HE+ 2=?=Y;>J/#@\G/D\.CR>]
MO_^\]%."D(58AAZ%1#'R1X?X_MZXO_4N&G%CM8&\IMIGF9 W4FL8!*C?JL)
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MV:U:C\<SR3EGILXDY9O.JLH>*[9\DNQ+BB8A&SL4J0"D;)U?OPWP+A$DP(L
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MU]<8< -&'Q<KH9VBT6#>*D8T%)RPR,:7XX34^%MD[\LI@]K3TT(;6#3*\DM
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M+D=R&Z]_/F$$/<+4AC_^'U!+ P04    " #1@DY.@ZAY11,O  "H\0( $P
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M0!;O*HS]>',3SB.RXC"_.V&C/HUOMH!?82]$;YSEXHQ-SUB[,^E09]W G,3
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MPU=?#Q.@45)L^!KO <,Q2K(=C]:LZ/<M43\>=;G9,5%B?3PJLW*8>HG\\:C
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M^]X#8PV[R-D?4]7 T>\+ (>5NU 0^9C(]W61OV&^1XIO^;42-VSV\PVOPX>
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M-=N!6#.,/3A3K/4_>@,<79JU\:?.O'5(/4+I?]^<V$G+N6U' $3^UHX;\,,
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M%?L0-0O>'I)JN/9\-L]1G7*DSETYSYPR92LIM7//&6<;$J\Y@SFC&\Q@]!@
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M_+11H#2*H.5&U>%81@]Q@BBE" 63(=1SFM23Z&4.'5)OJX)#; ASV'BYB]R
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MY7[<BE&)M>R :K:]U&6TW/0N*#P;!-)P3,<YE0(SWP.V<-S;7W.GJOFFK'F
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M']V_HG>4!?*"'U'.!15L8.ZG',T,R\P,:VJ&=X=,]7UF$ HDM,T-X4H-86Q
MH>WLE8&&GC'M1G/+W9@="%F);OV+)A>SLWEGE(-?M3FZ97BG76J5K1\^QV*<
M@][)V1T'W0 /?H>G0%3><*Y'&F\B  _T!JET3@@LU=)XSL76--[?#-4TGF;Q
MM/6B]6E;XMP**!89SV[T=DO;,D)6HKE3<EIV1K6M:7LXRS2F[2:<VYBV%7#0
M#?"VINUT*;-[VFXB  _T!JFTW/A4"> Y%UO3=G\S5--V=<X=YNI;G;PE+JZ
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M5'>T2X9JYVV@NN[DW5!=L975J+XC7(=)UB5*-N*Z$$]GN?7T:,%,%=B,WYM
M=F?+9-">O@EH'WMZ)VS7K&4WN)_#8:"=T;$2V*EP6BL^W6']'+X-4'>S2@;I
MD[<!Z9I_=P-TV5(6P_GN$4?8W2;"!E#Z=.R#<R&<1B>'T_FJ$YP+9E:#N;--
M>(&(5$G+('WLXQT@7;,7+*2S/O195_U65SAZ 02D=2ETTLC\>,4ZOVY!=KF
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MO.><[)GMC&41.PIL.OJU$+&*=@*&\#>\3X< U]N+<+<+@]LD7/_>[@BB%V&
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M8^=50F/-9D,L C0SNN"75--3O-E(DUVW+DAZO4@97Q[H)J>REYZ=GBV=?*V
MWX?(G?2\DBY*#//A/&(LQTZ>XF4$(Z:96FR:EB4&(_9QQK./F26)?C&E6)_H
M86VKABH:%_;ID+!A\-+OUKG5V4)E+F'797SCF:(*_-8KA,%',:I7[^E:S"KP
M_AI)5Q]E+]D 4":)Q@A[.3M5FE@PNI8AL(NN#'-?\,9;NWZIJ6A^>35ZQ/X&
M'8(-^>6:9Q[D8W>T#JL*BY?#*;\\"CBX^,(/HB\,'G<JD%2*-(5QK(HM5UZ
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M'&#ICB%2V>V>@3& :19LR6U%.74\#-Y@>@+VT$_<G YNI[$0,@^BIV,SS5N
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MZ=X$L5K0+"+\@1Y!P//Q8A7,A]\SC]YN8R1RTIO/FEBM276O4KENS[T.SQU
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M5Y!]J+]WB[HZB/(R].WP#;]TI"6V!6)0@)6QR)!5$BWC^>P0J3')5R3_ U$
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M+TZ!;182S$#7,,G\( )WV2M,&FMN#S#T,5ME<2.F1T!2XLB3X27!#V.7BOZ
MP<LK^FI7;S#Q7^#7'-^#R#R2W4LN(\L*X4@8*--Z+SB=HD(58+H 55;VEUS<
M&3Y=>#AE<<-5'E+>J$+R#;,SXA8$I6!%^SM!F.,HXADG5BCG'D61/.\&HR@
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M?T7"LT\(,S=^D/SNAWGG62(WC'M/Y"WDL02'+(>VS4[&ZSGAJ=;N.>(-P.X
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M9S*H:?30X E@UAT9)>N.-F%>]BKF7!2FK9_\ V;52O2*AHU=5)2!'Z_!ZA7
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M>,O+FAO*$TIQG%M-:-JG[HXGQIZM*]$;^A69%>F"%UN5$6R8E"_1 A0PGWJ
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M"#'<PW_\?U!+ 0(4 Q0    ( -&"3DZDAT??QG,! ,EP$P /
M  "  0    !M9"TR,#$X,3(S,2YX;6Q02P$"% ,4    " #1@DY.MOX[FB,7
M  !Q @$ #P              @ 'S<P$ ;60M,C Q.#$R,S$N>'-D4$L! A0#
M%     @ T8).3NX/,@5=&P  EIL! !,              ( !0XL! &UD+3(P
M,3@Q,C,Q7V-A;"YX;6Q02P$"% ,4    " #1@DY.@ZAY11,O  "H\0( $P
M            @ '1I@$ ;60M,C Q.#$R,S%?9&5F+GAM;%!+ 0(4 Q0    (
M -&"3DYI P_C%)\  ,[P"  3              "  176 0!M9"TR,#$X,3(S
M,5]L86(N>&UL4$L! A0#%     @ T8).3J4Q:#.34@  K24& !,
M     ( !6G4" &UD+3(P,3@Q,C,Q7W!R92YX;6Q02P4&      8 !@!^ 0
&'L@"

end
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
