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      <Form990PartVIISectionAGrp>
        <PersonNm>Migdalia Rivera</PersonNm>
        <TitleTxt>Member</TitleTxt>
        <AverageHoursPerWeekRt>0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1565147</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>46</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>LABORATORIOS TOLEDO</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>CALLE PALMA 51</AddressLine1Txt>
            <CityNm>ARECIBO</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>006124582</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HEALTH LABORATORY SERVICES</ServicesDesc>
        <CompensationAmt>562254</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>NATIONAL BUILDING MAINTENANCE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1350 EUCLID AVE STE 1500</AddressLine1Txt>
            <CityNm>CLEVELAND</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>44115</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CLEANING SERVICES</ServicesDesc>
        <CompensationAmt>629132</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <PersonNm>VISSEPO CONSTRUCTION</PersonNm>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 3607</AddressLine1Txt>
            <CityNm>MAYAGUEZ</CityNm>
            <StateAbbreviationCd>PR</StateAbbreviationCd>
            <ZIPCd>00681</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION COMPANY MAYAGUEZ MAIN SITE</ServicesDesc>
        <CompensationAmt>5864932</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
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          </USAddress>
        </ContractorAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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          <USAddress>
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            <ZIPCd>00908</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Consultants</ServicesDesc>
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      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>17</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
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      <RelatedOrganizationsAmt>0</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>23364776</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>0</AllOtherContributionsAmt>
      <NoncashContributionsAmt>0</NoncashContributionsAmt>
      <TotalContributionsAmt>23364776</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
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        <BusinessCd>621000</BusinessCd>
        <TotalRevenueColumnAmt>39040374</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>39040374</RelatedOrExemptFuncIncomeAmt>
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        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Capitation revenue</Desc>
        <BusinessCd>621000</BusinessCd>
        <TotalRevenueColumnAmt>86331059</TotalRevenueColumnAmt>
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      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
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        <RelatedOrExemptFuncIncomeAmt>6973246</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
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      <InvestmentIncomeGrp>
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      <IncmFromInvestBondProceedsGrp>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
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        <PersonalAmt>0</PersonalAmt>
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      <RentalIncomeOrLossGrp>
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        <PersonalAmt>0</PersonalAmt>
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      <NetRentalIncomeOrLossGrp>
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        <UnrelatedBusinessRevenueAmt>73425</UnrelatedBusinessRevenueAmt>
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      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
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      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>293684</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>286752</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>6932</UnrelatedBusinessRevenueAmt>
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      <TotalRevenueGrp>
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      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>623317</TotalAmt>
        <ProgramServicesAmt>183774</ProgramServicesAmt>
        <ManagementAndGeneralAmt>439543</ManagementAndGeneralAmt>
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      <CompDisqualPersonsGrp>
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        <ProgramServicesAmt>13233773</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6320898</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>8743445</TotalAmt>
        <ProgramServicesAmt>5765529</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2977916</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>2647070</ProgramServicesAmt>
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      <InterestGrp>
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        <ManagementAndGeneralAmt>72041</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>1356268</ProgramServicesAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>7151104</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>Claim payments</Desc>
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      <OtherExpensesGrp>
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        <EOYAmt>210735</EOYAmt>
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        <EOYAmt>9133701</EOYAmt>
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        <EOYAmt>125404886</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
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      <TotLiabNetAssetsFundBalanceGrp>
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        <EOYAmt>134538587</EOYAmt>
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      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
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        <BookValueAmt>3142939</BookValueAmt>
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      <BuildingsGrp>
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      <OtherAssetsOrgGrp>
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        <Desc>Operating Leases obligation</Desc>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Deferred compensation plan</Desc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part XI, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The audited financial statements are consolidated with Laboratorio Clínico Hormigueros, LLC with EIN 66-0942441. Form 990 is reporting only the operations of the exempt organization.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part XII, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The audited financial statements are consolidated with Laboratorio Clínico Hormigueros, LLC with EIN 66-0942441. Form 990 is reporting only the operations of the exempt organization.</ExplanationTxt>
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      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
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      <InitialContractExceptionInd>0</InitialContractExceptionInd>
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        <PersonNm>TANIA RODRIGUEZ MORALES</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Luis Acosta Garcia</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>200923</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EFRAIN ARROYO PENA</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>195774</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>195774</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Angel Guerra Torres</PersonNm>
        <TitleTxt>PSYCHIATRIST</TitleTxt>
        <BaseCompensationFilingOrgAmt>178466</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Veronica Ortiz Rodriguez</PersonNm>
        <TitleTxt>GENERALIST PHYSICIAN / CLINICAL DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>173058</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Carlos Del Valle</PersonNm>
        <TitleTxt>General Physician</TitleTxt>
        <BaseCompensationFilingOrgAmt>161103</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <TotalCompensationFilingOrgAmt>161103</TotalCompensationFilingOrgAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="R000005" softwareId="23018249" softwareVersionNum="v1.00">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 8b</FormAndLineReferenceDesc>
        <ExplanationTxt>No Committee acts on behalf of the governing body</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Finance Director presents form 990 to board meeting. The board discusses and approves form 990. The Chairman of the board signs the copy of the form 990 as evidence of review and approval. The board file the meeting's minute and signed copy of the form 990 is available for inspection.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The entity compliance department is responsible to monitor, audit, and to follow up all the matters related with the conflict of interest and whistleblower policies.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The board of directors approves all salary increases including the executive director salary.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 18</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 and related documents are available for inspection upon request to all federal and state governmental agencies and to the general public at our main offices physical address.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>- Form 990 and related documents are available for inspection upon request to all federal and state governmental agencies and to the general public at our main offices physical address.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>