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<!-- 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. -->
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  <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>
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  <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>
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  <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>
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  <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>
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  <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>
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  <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>
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  <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>
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  <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>
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  <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>
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  <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>
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  <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>
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