Astrana Health (ASTH) 10-Q 10 May 19 2019 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2019	May 03, 2019
Document and Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1
Entity Registrant Name	Apollo Medical Holdings, Inc.
Entity Central Index Key	0001083446
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Trading Symbol	AMEH
Entity Common Stock, Shares Outstanding		35,768,076
Entity Emerging Growth Company	false
Entity Small Business	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($)	Mar. 31, 2019	Dec. 31, 2018
Current assets
Cash and cash equivalents	$ 93,007,780	$ 106,891,503
Investment in marketable securities	1,143,006	1,127,102
Receivables, net	6,640,236	7,127,217
Receivables, net – related parties	55,888,846	49,328,739
Other receivables	12,247,776	1,003,133
Prepaid expenses and other current assets	7,984,419	7,385,098
Total current assets	176,912,063	172,862,792
Noncurrent assets
Land, property and equipment, net	12,332,342	12,721,082
Intangible assets, net	83,056,658	86,875,883
Goodwill	185,805,880	185,805,880
Loans receivable – related parties	17,500,000	17,500,000
Investments in other entities – equity method	34,027,323	34,876,980
Investment in a privately held entity that does not report net asset value per share	405,000	405,000
Restricted cash	740,212	745,470
Right-of-use assets	8,528,159	0
Other assets	1,551,359	1,205,962
Total noncurrent assets	343,946,933	340,136,257
Total assets	520,858,996	512,999,049
Current liabilities
Accounts payable and accrued expenses	47,654,471	25,075,489
Fiduciary accounts payable	2,084,926	1,538,598
Medical liabilities	23,265,865	33,641,701
Income taxes payable	12,831,839	11,621,861
Bank loan	0	40,257
Finance lease obligation	101,741	101,741
Lease liabilities	2,461,924	0
Total current liabilities	88,400,766	72,019,647
Noncurrent liabilities
Lines of credit - related party	13,000,000	13,000,000
Deferred tax liability	16,992,790	19,615,935
Liability for unissued equity shares	1,185,025	1,185,025
Finance lease obligation	492,110	517,261
Lease liabilities	5,977,145	0
Total noncurrent liabilities	37,647,070	34,318,221
Total liabilities	126,047,836	106,337,868
Commitments and Contingencies (Note 10)
Mezzanine equity
Noncontrolling interest in Allied Pacific of California IPA ("APC")	212,434,390	225,117,029
Shareholders' equity
Common stock, par value $0.001; 100,000,000 shares authorized, 34,503,704 and 34,578,040 shares outstanding, excluding 1,944,054 and 1,850,603 treasury shares, at March 31, 2019 and December 31, 2018, respectively	34,504	34,578
Additional paid-in capital	163,005,851	162,723,051
Retained earnings	17,927,867	17,788,203
Stockholders' deficit attributable to Apollo Medical Holdings, Inc.	180,968,222	180,545,832
Noncontrolling interest	1,408,548	998,320
Total stockholders' equity	182,376,770	181,544,152
Total liabilities, mezzanine equity and stockholders' equity	520,858,996	512,999,049
Series A Preferred Stock [Member]
Shareholders' equity
Preferred Stock Value	0	0
Series B Preferred Stock [Member]
Shareholders' equity
Preferred Stock Value	$ 0	$ 0

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2019	Dec. 31, 2018
Common Stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common Stock, shares authorized	100,000,000	100,000,000
Common Stock, shares outstanding	34,503,704	34,578,040
Treasury Stock, Common, Shares	1,944,054	1,850,603
Series A Preferred Stock [Member]
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	1,111,111	1,111,111
Preferred Stock, Shares Outstanding	0	0
Series B Preferred Stock [Member]
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	555,555	555,555
Preferred Stock, Shares Outstanding	0	0

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF INCOME - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenue
Total revenue	$ 95,757,171	$ 123,923,246
Operating expenses
Cost of services	83,432,474	84,614,686
General and administrative expenses	10,263,960	11,301,237
Depreciation and amortization	4,417,581	5,058,512
Provision for doubtful accounts	951,014	247,102
Total expenses	99,065,029	101,221,537
(Loss) income from operations	(3,307,858)	22,701,709
Other income (expense)
Loss from equity method investments	(849,657)	(28,024)
Interest expense	(210,979)	(85,001)
Interest income	323,008	269,818
Other income	187,116	87,993
Total other (expense) income, net	(550,512)	244,786
(Loss) income before (benefit from) provision for income taxes	(3,858,370)	22,946,495
(Benefit from) provision for income taxes	(1,408,241)	7,228,840
Net (loss) income	(2,450,129)	15,717,655
Net (loss) income attributable to noncontrolling interest	(2,589,793)	13,557,200
Net income attributable to Apollo Medical Holdings, Inc.	$ 139,664	$ 2,160,455
Earnings per share – basic	$ 0	$ 0.07
Earnings per share – diluted	$ 0	$ 0.06
Weighted average shares of common stock outstanding – basic	34,496,622	32,421,467
Weighted average shares of common stock outstanding – diluted	38,074,174	38,098,373
Capitation, net [Member]
Revenue
Total revenue	$ 71,516,778	$ 85,905,284
Health Care, Other [Member]
Revenue
Total revenue	10,093,841	17,986,736
Management Service [Member]
Revenue
Total revenue	8,996,600	12,074,572
Health Care, Patient Service [Member]
Revenue
Total revenue	4,080,674	6,236,628
Product and Service, Other [Member]
Revenue
Total revenue	$ 1,069,278	$ 1,720,026

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF MEZZANINE AND SHAREHOLDERS' EQUITY - USD ($)	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Noncontrolling Interest [Member]	Noncontrolling Interest [Member]Mezzanine [Member]
Balance at Dec. 31, 2017	$ 164,183,426	$ 32,305	$ 158,181,192	$ 1,734,531	$ 4,235,398	$ 172,129,744
Balance (in shares) at Dec. 31, 2017		32,304,876
ASC 606 Adoption at Dec. 31, 2017	1,002,468			1,002,468		7,351,434
Net (loss) income	15,717,655	$ 0	0	2,160,455	586,448	12,970,752
Shares issued for exercise of options and warrants	1,923,784	$ 310	1,923,474	0	0	0
Shares issued for exercise of options and warrants (in shares)		309,826
Share-based compensation	631,562	$ 38	631,524	0	0	202,382
Share-based compensation (in shares)		37,593
Dividends	0	$ 0	0	0	0	(2,000,000)
Balance at Mar. 31, 2018	170,488,143	$ 32,653	160,736,190	4,897,454	4,821,846	190,654,312
Balance (in shares) at Mar. 31, 2018		32,652,295
Balance at Dec. 31, 2018	181,544,152	$ 34,578	162,723,051	17,788,203	998,320	225,117,029
Balance (in shares) at Dec. 31, 2018		34,578,040
Net (loss) income	(2,450,129)	$ 0	0	139,664	410,228	(3,000,021)
Purchase of treasury shares	0	$ (93)	93	0	0	(40,000)
Purchase of treasury shares (shares)		(93,451)
Shares issued for exercise of options and warrants	139,974	$ 17	139,957	0	0	155,000
Shares issued for exercise of options and warrants (in shares)		17,516
Share-based compensation	142,752	$ 2	142,750	0	0	202,382
Share-based compensation (in shares)		1,599
Dividends	0	$ 0	0	0	0	(10,000,000)
Balance at Mar. 31, 2019	$ 182,376,770	$ 34,504	$ 163,005,851	$ 17,927,867	$ 1,408,548	$ 212,434,390
Balance (in shares) at Mar. 31, 2019		34,503,704

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cash flows from operating activities
Net (loss) income	$ (2,450,129)	$ 15,717,655
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	4,417,581	5,058,512
Loss of disposal of property and equipment	0	41,782
Provision for doubtful accounts	951,014	247,102
Share-based compensation	345,134	833,944
Unrealized (gain) loss from investment in equity securities	(7,727)	8,550
Loss from equity method investments	849,657	28,024
Deferred tax	(2,623,145)	2,807,407
Changes in operating assets and liabilities:
Receivable, net	486,981	1,296,519
Receivable, net – related parties	(7,511,121)	(22,631,440)
Other receivables	(11,244,643)	0
Prepaid expenses and other current assets	(728,631)	232,392
Right-of-use assets	447,960
Other assets	(442,882)	(59,444)
Accounts payable and accrued expenses	22,578,982	(1,169,363)
Incentives payable	0	(6,600,000)
Fiduciary accounts payable	546,328	(630,963)
Medical liabilities	(10,375,836)	5,138,508
Income taxes payable	1,209,978	4,416,174
Lease liabilities	(416,255)	0
Net cash (used in) provided by operating activities	(3,966,754)	4,735,359
Cash flows from investing activities
Purchases of marketable securities	(8,177)	(3,932)
Purchases of property and equipment	(103,616)	(485,121)
Net cash used in investing activities	(111,793)	(489,053)
Cash flows from financing activities
Repayments on bank loan	(40,257)	(140,608)
Dividends paid	(10,000,000)	(2,000,000)
Payment of capital lease obligations	(25,151)	(24,407)
Proceeds from exercise of stock options and warrants	139,974	1,923,784
Repurchase of shares	(40,000)	0
Proceeds from common stock offering	155,000	0
Net cash used in financing activities	(9,810,434)	(241,231)
Net (decrease) increase in cash, cash equivalents and restricted cash	(13,888,981)	4,005,075
Cash, cash equivalents and restricted cash, beginning of period	107,636,973	118,500,095
Cash, cash equivalents and restricted cash, end of period	93,747,992	122,505,170
Supplemental disclosures of cash flow information
Cash paid for income taxes	0	0
Cash paid for interest	181,819	73,610
Supplemental disclosures of non-cash investing and financing activities
Cashless exercise of stock options	0	43
Deferred tax liability adjusted to goodwill	0	914,011
Reconciliation of cash, cash equivalents, and restricted cash
Cash and cash equivalents	93,007,780	103,731,761
Restricted cash – short-term - distributions to former NMM shareholders	0	18,028,116
Restricted cash – long-term - letters of credit	740,212	745,293
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows	$ 93,747,992	$ 122,505,170

Description of Business

Description of Business	3 Months Ended
	Mar. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of Business	1. Description of Business Overview Apollo Medical Holdings, Inc. (“ApolloMed”), entered into an Agreement and Plan of Merger dated as of December 21, 2016 (as amended on March 30, 2017 and October 17, 2017) (the “Merger Agreement”) among ApolloMed, Apollo Acquisition Corp., a California corporation and wholly-owned subsidiary of ApolloMed, Network Medical Management, Inc. (“NMM”), and Kenneth Sim, M.D., not individually but in his capacity as the representative of the shareholders of NMM, pursuant to which ApolloMed effected a merger with NMM (the “Merger”). The Merger closed and became effective on December 8, 2017 (the “Closing”). As a result of the Merger, NMM is now a wholly-owned subsidiary of ApolloMed and the former NMM shareholders own a majority of the issued and outstanding common stock of ApolloMed. For accounting purposes, the Merger is treated as a “reverse acquisition,” and NMM is considered the accounting acquirer and ApolloMed is the accounting acquiree. Accordingly, as of the Closing, NMM’s historical results of operations replaced ApolloMed’s historical results of operations for all periods prior to the Merger, and the results of operations of both companies are included in the accompanying condensed consolidated financial statements for all periods following the Merger. The combined company, following the Merger, together with its affiliated physician groups and consolidated entities (collectively, the “Company”), is a physician-centric integrated population health management company providing coordinated, outcomes-based medical care in a cost-effective manner and serving patients in California, the majority of whom are covered by private or public insurance provided through Medicare, Medicaid and health maintenance organizations (“HMOs”). A small portion of the Company’s revenue is generated from non-insured patients. The Company provides care coordination services to each major constituent of the healthcare delivery system, including patients, families, primary care physicians, specialists, acute care hospitals, alternative sites of inpatient care, physician groups and health plans. The Company’s physician network consists of primary care physicians, specialist physicians and hospitalists. The Company operates primarily through the following subsidiaries of ApolloMed: NMM, Apollo Medical Management, Inc. (“AMM”), APAACO and Apollo Care Connect, Inc. (“Apollo Care Connect”), and their consolidated entities. NMM was formed in 1994 as a management service organization (“MSO”) for the purposes of providing management services to medical companies and independent practice associations (“IPAs”). The management services include primarily billing, collection, accounting, administrative, quality assurance, marketing, compliance and education. Allied Physicians of California IPA, a Professional Medical Corporation d.b.a. Allied Pacific of California IPA (“APC”) was incorporated on August 17, 1992 for the purpose of arranging health care services as an IPA. APC has contracts with various HMOs or licensed health care service plans as defined in the California Knox-Keene Health Care Service Plan Act of 1975. Each HMO negotiates a fixed amount per member per month (“PMPM”) that is to be paid to APC. In return, APC arranges for the delivery of health care services by contracting with physicians or professional medical corporations for primary care and specialty care services. APC assumes the financial risk of the cost of delivering health care services in excess of the fixed amounts received. Some of the risk is transferred to the contracted physicians or professional corporations. The risk is also minimized by stop-loss provisions in contracts with HMOs. On July 1, 1999, APC entered into an amended and restated management and administrative services agreement with NMM (the initial management services agreement was entered into in 1997) for an initial fixed term of 30 years. In accordance with relevant accounting guidance, APC is determined to be a variable interest entity (“VIE”) of the Company as NMM is the primary beneficiary with the ability to direct the activities (excluding clinical decisions) that most significantly affect APC’s economic performance through its majority representation on the APC Joint Planning Board; therefore APC is consolidated by NMM. As of March 31, 2019 and December 31, 2018, APC had an ownership interest of 4.89% and 4.82% in ApolloMed, respectively. Concourse Diagnostic Surgery Center, LLC (“CDSC”) was formed on March 25, 2010 in the state of California. CDSC is an ambulatory surgery center in City of Industry, California. Its facility is Medicare Certified and accredited by the Accreditation Association for Ambulatory Healthcare, Inc. During 2011, APC invested $0.6 million for a 41.59% ownership interest in CDSC. APC’s ownership percentage in CDSC’s capital stock increased to 43.43% on July 31, 2016. CDSC is consolidated as a VIE by APC as it was determined that APC has a controlling financial interest in CDSC and is the primary beneficiary of CDSC. APC-LSMA was formed on October 15, 2012 as a designated shareholder professional corporation. Dr. Thomas Lam, a shareholder, Chief Executive and Financial Officer of APC and CEO of ApolloMed, is a nominee shareholder of APC. APC makes all the investment decisions on behalf of APC-LSMA, funds these investments and receives all the distributions from the investments. APC has the obligation to absorb losses or rights to receive benefits from all the investments made by APC-LSMA. APC-LSMA’s sole function is to act as the nominee shareholder for APC in other California medical professional corporations. Therefore, APC-LSMA is controlled and consolidated by APC who is the primary beneficiary of this VIE. The only activity of APC-LSMA is to hold the investments in medical corporations, including the IPA line of business of LaSalle Medical Associates (“LMA”), Pacific Medical Imaging and Oncology Center, Inc. (“PMIOC”), Diagnostic Medical Group (“DMG”) and AHMC International Cancer Center (“ICC”). ICC was formed on September 2, 2010 in the state of California. ICC is a Professional Medical California Corporation and has entered into agreements with HMOs, IPAs, medical groups and other purchasers of medical services for the arrangement of services to subscribers or enrollees. On November 15, 2016, APC-LSMA, a holding company of APC, agreed to purchase and acquire from ICC 40% of the aggregate issued and outstanding shares of capital stock of ICC for $0.4 million in cash. Certain requirements to complete the investment transaction was completed in August 2017 and effective on October 31, 2017, ICC was determined to be a VIE of APC and is consolidated by APC as it was determined that APC is the primary beneficiary of ICC through its obligation to absorb losses and right to receive benefits that could potentially be significant to ICC. Universal Care Acquisition Partners, LLC (“UCAP”), a 100% owned subsidiary of APC, was formed on June 4, 2014, for the purpose of holding an investment in Universal Care, Inc. (“UCI”). APAACO, jointly owned by NMM and AMM, began participating in the next generation accountable care organization model (“NGACO Model”) of the CMS in January 2017. The NGACO Model is a new CMS program that allows provider groups to assume higher levels of financial risk and potentially achieve a higher reward from participating in this new attribution-based risk sharing model. In addition to APAACO, NMM and AMM operated three accountable care organizations (“ACOs”) that participated in the Medicare Shared Savings Program (“MSSP”), with the goal of improving the quality of patient care and outcomes through a more efficient and coordinated approach among providers. MSSP revenues are uncertain, and, if such amounts are payable by CMS, they will be paid on an annual basis significantly after the time earned, and are contingent on various factors, including achievement of the minimum savings rate for the relevant period. Such payments are earned and made on an “all or nothing” basis. AMM, a wholly-owned subsidiary of ApolloMed, manages affiliated medical groups, which consist of ApolloMed Hospitalists (“AMH”), a hospitalist company, Southern California Heart Centers (“SCHC”), Bay Area Hospitalist Associates (“BAHA”), a medical corporation, ApolloMed Care Clinic (“ACC”) and AKM Medical Group, Inc. (“AKM”). AMH provides hospitalist, intensivist and physician advisor services. SCHC is a specialty clinic that focuses on cardiac care and diagnostic testing. BAHA, ACC and AKM are no longer active to any material extent. Apollo Care Connect, a wholly-owned subsidiary of ApolloMed, provides a cloud and mobile-based population health management platform that includes digital care plans, a case management module, connectivity with multiple healthcare tracking devices and the ability to integrate with multiple electronic health records to capture clinical data.

Basis of Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
Basis of Presentation	2. Basis of Presentation Basis of Presentation The accompanying condensed consolidated balance sheet at December 31, 2018, has been derived from audited consolidated financial statements, but does not include all disclosures required by accounting principles generally accepted in the United States of America (“U.S. GAAP”). The accompanying unaudited condensed consolidated financial statements as of March 31, 2019 and for the three months ended March 31, 2019 and 2018, have been prepared in accordance with U.S. GAAP for interim financial information and with the instructions to Form 10-Q and Article 8 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by U.S. GAAP for complete financial statements, and should be read in conjunction with the audited consolidated financial statements and related notes to the financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2018 as filed with the U.S. Securities and Exchange Commission (“SEC”) on March 18, 2019. In the opinion of management, all material adjustments (consisting of normal recurring adjustments) considered necessary for a fair presentation have been made to the condensed consolidated financial statements. The condensed consolidated financial statements include all material adjustments (consisting of normal recurring accruals) necessary to make the condensed consolidated financial statements not misleading as required by Regulation S-X, Rule 10-01. The Company’s quarterly results fluctuate. Operating results for the three months ended March 31, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019 or any future periods. Principles of Consolidation The condensed consolidated balance sheets as of March 31, 2019 and December 31, 2018, and the condensed consolidated statements of income for the three months ended March 31, 2019 and 2018, include the accounts of ApolloMed, its consolidated subsidiaries NMM, AMM, APAACO and Apollo Care Connect, including NMM’s subsidiaries, APCN-ACO and AP-ACO, NMM’s consolidated VIE, APC, APC’s subsidiary, UCAP, and APC’s consolidated VIEs, CDSC, APC-LSMA and ICC. All material intercompany balances and transactions have been eliminated in consolidation. Use of Estimates The preparation of the condensed consolidated financial statements and related disclosures in conformity with U.S. GAAP 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 consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Significant items subject to such estimates and assumptions include collectability of receivables, recoverability of long-lived and intangible assets, business combination and goodwill valuation and impairment, accrual of medical liabilities (including historical medical loss ratios (“MLR”), and incurred, but not reported (“IBNR”) claims), determination of full-risk and shared-risk revenue and receivables (including constraints and completion factors), income taxes, valuation of share-based compensation and right of use assets and lease liabilities. Management evaluates its estimates and assumptions on an ongoing basis using historical experience and other factors, including the current economic environment, and makes adjustments when facts and circumstances dictate. As future events and their effects cannot be determined with precision, actual results could differ materially from those estimates and assumptions. Reportable Segments The Company operates as one reportable segment, the healthcare delivery segment, and implements and operates innovative health care models to create a patient-centered, physician-centric experience. The Company reports its condensed consolidated financial statements in the aggregate, including all activities in one reportable segment. Reclassifications Certain amounts disclosed in prior period financial statements have been reclassified to conform to the current period presentation. These reclassifications had no material effect on the Company’s reported revenue, net income, cash flows or total assets. Cash and Cash Equivalents The Company’s cash and cash equivalents primarily consist of money market funds and certificates of deposit. The Company considers all highly liquid investments that are both readily convertible into known amounts of cash and mature within ninety days from their date of purchase to be cash equivalents. The Company maintains its cash in deposit accounts with several banks, which at times may exceed the insured limits of the Federal Deposit Insurance Corporation (“FDIC”). The Company believes it is not exposed to any significant credit risk with respect to its cash, cash equivalents and restricted cash. As of March 31, 2019, the Company’s deposit accounts with banks exceeded the FDIC’s insured limit by approximately $110.0 million. The Company has not experienced any losses to date and performs ongoing evaluations of these financial institutions to limit the Company’s concentration of risk exposure. Investments in Marketable Securities The appropriate classification of investments is determined at the time of purchase and such designation is reevaluated at each balance sheet date. Investments in marketable debt securities have been classified and accounted for as held-to-maturity based on management’s investment intentions relating to these securities. Held-to-maturity marketable securities are stated at amortized cost, which approximates fair value. As of March 31, 2019 and December 31, 2018, short-term marketable securities in the amount of approximately $1.1 million, consist of certificates of deposit with various financial institutions, reported at par value plus accrued interest, with maturity dates from four months to twelve months (see fair value measurements of financial instruments below). Investments in certificates of deposits are classified as Level 1 investments in the fair value hierarchy. Receivables and Receivables – Related Parties The Company’s receivables are comprised of accounts receivable, capitation and claims receivable, risk pool settlements and incentive receivables, management fee income and other receivables. Accounts receivable are recorded and stated at the amount expected to be collected. The Company’s receivables – related parties are comprised of risk pool settlements and incentive receivables, management fee income and other receivables. Receivables – related parties are recorded and stated at the amount expected to be collected. Capitation and claims receivable relate to each health plan’s capitation, which is received by the Company in the month following the month of service. Risk pool settlements and incentive receivables mainly consist of the Company’s full risk pool receivable that is recorded quarterly based on reports received from our hospital partners and management’s estimate of the Company’s portion of the estimated risk pool surplus for open performance years. Settlement of risk pool surplus or deficits occurs approximately 18 months after the risk pool performance year is completed. During the three months ended March 31, 2019, recoverable claims paid related to the 2019 APAACO performance year to be administered following instructions from CMS, fee-for-services (“FFS”) reimbursement for patient care, certain expense reimbursements, transportation reimbursements from the hospitals, and stop loss insurance premium reimbursements are included in “Other receivables” in the accompanying condensed consolidated balance sheet. The Company maintains reserves for potential credit losses on accounts receivable. Management reviews the composition of accounts receivable and analyzes historical bad debts, customer concentrations, customer credit worthiness, current economic trends and changes in customer payment patterns to evaluate the adequacy of these reserves. The Company also regularly analyses the ultimate collectability of accounts receivable after certain stages of the collection cycle using a look-back analysis to determine the amount of receivables subsequently collected and adjustments are recorded when necessary. Reserves are recorded primarily on a specific identification basis. Amounts are recorded as a receivable when the Company is able to determine amounts receivable under these contracts and/or agreements based on information provided and collection is reasonably likely to occur. The Company continuously monitors its collections of receivables and its policy is to write off receivables when they are determined to be uncollectible. As of March 31, 2019 and December 31, 2018, the Company’s allowance for doubtful accounts was approximately $5.2 million and approximately $4.3 million, respectively. Concentrations of Risks The Company disaggregates revenue from contracts by service type and by payor. This level of detail provides useful information pertaining to how the Company generates revenue by significant revenue stream and by type of direct contracts. The consolidated statements of income present disaggregated revenue by service type. The following table presents disaggregated revenue generated by each payor type for the three months ended March 31, 2019 and 2018 : Three Months Ended March 31, 2019 2018 Commercial $ 31,784,992 $ 105,106,621 Medicare 22,947,690 18,541,115 Medicaid 32,820,500 176,350 Other third parties 8,203,989 99,160 Revenue $ 95,757,171 $ 123,923,246 The Company had major payors that contributed the following percentage of net revenue: For the Three Months Ended March 31, 2019 2018 Payor A 17.4 % * % Payor B 15.3 % 12.0 % Payor C 12.0 % 10.9 % * Less than 10% of total net revenues The Company had major payors that contributed to the following percentage of receivables and receivables – related parties before the allowance for doubtful accounts: As of March 31, 2019 As of December 31, 2018 Payor D 35.3 % 34.1 % Payor E 42.9 % 42.2 % Fair Value Measurements of Financial Instruments The Company’s financial instruments consist of cash and cash equivalents, fiduciary cash, restricted cash, investment in marketable securities, receivables, loans receivable, accounts payable, certain accrued expenses, capital lease obligations, bank loan and the line of credit. The carrying values of the financial instruments classified as current in the accompanying condensed consolidated balance sheets are considered to be at their fair values, due to the short maturity of these instruments. The carrying amounts of the loan receivables – long term, bank loan, capital lease obligations and line of credit approximate fair value as they bear interest at rates that approximate current market rates for debt with similar maturities and credit quality. Financial Accounting Standards Board (“FASB”) ASC 820, Fair Value Measurement (“ASC 820”), applies to all financial assets and financial liabilities that are measured and reported on a fair value basis and requires disclosure that establishes a framework for measuring fair value and expands disclosure about fair value measurements. ASC 820 establishes a fair value hierarchy for disclosures of the inputs to valuations used to measure fair value. This hierarchy prioritizes the inputs into three broad levels as follows: Level 1 —Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that can be accessed at the measurement date. Level 2 —Inputs include quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets or liabilities in markets that are not active, inputs other than quoted prices that are observable for the asset or liability (i.e., interest rates and yield curves), and inputs that are derived principally from or corroborated by observable market data by correlation or other means (market corroborated inputs). Level 3 —Unobservable inputs that reflect assumptions about what market participants would use in pricing the asset or liability. These inputs would be based on the best information available, including the Company’s own data. The carrying amounts and fair values of the Company’s financial instruments as of March 31, 2019 are presented below: Fair Value Measurements Level 1 Level 2 Level 3 Total Assets Money market funds* $ 68,004,532 $ - $ - $ 68,004,532 Marketable securities – certificates of deposit 1,074,280 - - 1,074,280 Marketable securities – equity securities 68,726 - - 68,726 Total $ 69,147,538 $ - $ - $ 69,147,538 The carrying amounts and fair values of the Company’s financial instruments as of December 31, 2018 are presented below: Fair Value Measurements Level 1 Level 2 Level 3 Total Assets Money market funds* $ 85,500,745 $ - $ - $ 85,500,745 Marketable securities – certificates of deposit 1,066,103 - - 1,066,103 Marketable securities – equity securities 60,999 - - 60,999 Total $ 86,627,847 $ - $ - $ 86,627,847 * Included in cash and cash equivalents There were no Level 3 inputs measured on a recurring basis for the three months ended March 31, 2019. There have been no changes in Level 1, Level 2, or Level 3 classification and no changes in valuation techniques for these assets for the three months ended March 31, 2019 and December 31, 2018. Intangible Assets and Long-Lived Assets Intangible assets with finite lives include network-payor relationships, management contracts and member relationships and are stated at cost, less accumulated amortization and impairment losses. These intangible assets are amortized on the accelerated method using the discounted cash flow rate. Intangible assets with finite lives also include a patient management platform, as well as trade names and trademarks, whose valuations were determined using the cost to recreate method and the relief from royalty method, respectively. These assets are stated at cost, less accumulated amortization and impairment losses, and are amortized using the straight-line method. Finite-lived intangibles and long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. If the expected future cash flows from the use of such assets (undiscounted and without interest charges) are less than the carrying value, a write-down would be recorded to reduce the carrying value of the asset to its estimated fair value. Fair value is determined based on appropriate valuation techniques. The Company determined that there was no impairment of its finite-lived intangible or long-lived assets during the three months ended March 31, 2019 and 2018. Goodwill and Indefinite-Lived Intangible Assets Under the ASC 350, Intangibles – Goodwill and Other (“ASC 350”), goodwill and indefinite-lived intangible assets are reviewed at least annually for impairment. At least annually, at the Company’s fiscal year end, or sooner if events or changes in circumstances indicate that an impairment has occurred, the Company performs a qualitative assessment to determine whether it is more likely than not that the fair value of each reporting unit is less than its carrying amount as a basis for determining whether it is necessary to complete quantitative impairment assessments for each of the Company’s three main reporting units (1) management services, (2) IPA, and (3) ACO. The Company is required to perform a quantitative goodwill impairment test only if the conclusion from the qualitative assessment is that it is more likely than not that a reporting unit’s fair value is less than the carrying value of its assets. Should this be the case, a quantitative analysis is performed to identify whether a potential impairment exists by comparing the estimated fair values of the reporting units with their respective carrying values, including goodwill. An impairment loss is recognized if the implied fair value of the asset being tested is less than its carrying value. In this event, the asset is written down accordingly. The fair values of goodwill are determined using valuation techniques based on estimates, judgments and assumptions management believes are appropriate in the circumstances. At least annually, indefinite-lived intangible assets are tested for impairment. Impairment for intangible assets with indefinite lives exists if the carrying value of the intangible asset exceeds its fair value. The fair values of indefinite-lived intangible assets are determined using valuation techniques based on estimates, judgments and assumptions management believes are appropriate in the circumstances. The Company determined that there was no impairment of its goodwill or indefinite-lived intangible assets during the three months ended March 31, 2019 and 2018. Investments in Other Entities - Equity Method The Company accounts for certain investments using the equity method of accounting when it is determined that the investment provides the Company with the ability to exercise significant influence, but not control, over the investee. Significant influence is generally deemed to exist if the Company has an ownership interest in the voting stock of the investee of between 20% and 50%, although other factors, such as representation on the investee’s board of directors, are considered in determining whether the equity method of accounting is appropriate. Medical Liabilities APC, APAACO and MMG are responsible for integrated care that the associated physicians and contracted hospitals provide to its enrollees. APC, APAACO and MMG provide integrated care to HMOs, Medicare and Medi-Cal enrollees through a network of contracted providers under sub-capitation and direct patient service arrangements. Medical costs for professional and institutional services rendered by contracted providers are recorded as cost of services expenses in the accompanying condensed consolidated statements of income. An estimate of amounts due to contracted physicians, hospitals, and other professional providers is included in medical liabilities in the accompanying condensed consolidated balance sheets. Medical liabilities include claims reported as of the balance sheet date and estimates IBNR claims. Such estimates are developed using actuarial methods and are based on numerous variables, including the utilization of health care services, historical payment patterns, cost trends, product mix, seasonality, changes in membership, and other factors. The estimation methods and the resulting reserves are periodically reviewed and updated. Many of the medical contracts are complex in nature and may be subject to differing interpretations regarding amounts due for the provision of various services. Such differing interpretations may not come to light until a substantial period of time has passed following the contract implementation. Revenue Recognition The Company adopted Accounting Standards Update (“ASU”) 2014-09, “Revenue from Contracts with Customers (Topic 606)” on January 1, 2018 and recognizes revenue in accordance with the applicable guidance. The Company receives payments from the following sources for services rendered: (i) commercial insurers; (ii) the federal government under the Medicare program administered by CMS; (iii) state governments under the Medicaid and other programs; (iv) other third party payors (e.g., hospitals and IPAs); and (v) individual patients and clients. Nature of Services and Revenue Streams Revenue primarily consists of capitation revenue, risk pool settlements and incentives, NGACO All-Inclusive Population-Based Payments (“AIPBP”) revenue, management fee income, and FFS revenue. Revenue is recorded in the period in which services are rendered or the period in which the Company is obligated to provide services. The form of billing and related risk of collection for such services may vary by type of revenue and the customer. The following is a summary of the principal forms of the Company’s billing arrangements and how revenue is recognized for each. Capitation, net Managed care revenues of the Company consist primarily of capitated fees for medical services provided by the Company under a capitated arrangement directly made with various managed care providers including HMOs. Capitation revenue is typically prepaid monthly to the Company based on the number of enrollees selecting the Company as their healthcare provider. Capitation revenue is recognized in the month in which the Company is obligated to provide services to plan enrollees under contracts with various health plans. Minor ongoing adjustments to prior months’ capitation, primarily arising from contracted HMOs finalizing their monthly patient eligibility data for additions or subtractions of enrollees, are recognized in the month they are communicated to the Company. Additionally, Medicare pays capitation using a “Risk Adjustment” model, which compensates managed care organizations and providers based on the health status (acuity) of each individual enrollee. Health plans and providers with higher acuity enrollees will receive more and those with lower acuity enrollees will receive less. Under Risk Adjustment, capitation is determined based on health severity, measured using patient encounter data. Capitation is paid on a monthly basis based on data submitted for the enrollee for the preceding year and is adjusted in subsequent periods after the final data is compiled. Positive or negative capitation adjustments are made for Medicare enrollees with conditions requiring more or less healthcare services than assumed in the interim payments. Since the Company cannot reliably predict these adjustments, periodic changes in capitation amounts earned as a result of Risk Adjustment are recognized when those changes are communicated by the health plans to the Company. PMPM managed care contracts generally have a term of one year or longer. All managed care contracts have a single performance obligation that constitutes a series for the provision of managed healthcare services for a population of enrolled members for the duration of the contract. The transaction price for PMPM contracts is variable as it primarily includes PMPM fees associated with unspecified membership that fluctuates throughout the contract. In certain contracts, PMPM fees also include adjustments for items such as performance incentives, performance guarantees and risk shares. The Company generally estimates the transaction price using the most likely methodology and amounts are only included in the net transaction price to the extent that it is probable that a significant reversal of cumulative revenue will not occur once any uncertainty is resolved. The majority of the Company’s net PMPM transaction price relates specifically to the Company’s efforts to transfer the service for a distinct increment of the series (e.g. day or month) and is recognized as revenue in the month in which members are entitled to service. Risk Pool Settlements and Incentives APC enters into full risk capitation arrangements with certain health plans and local hospitals, which are administered by a third party, where the hospital is responsible for providing, arranging and paying for institutional risk and APC is responsible for providing, arranging and paying for professional risk. Under a full risk pool sharing agreement, APC generally receives a percentage of the net surplus from the affiliated hospital’s risk pools with HMOs after deductions for the affiliated hospital’s costs. Advance settlement payments are typically made quarterly in arrears if there is a surplus. Risk pool settlements under arrangements with health plans and hospitals are recognized using the most likely methodology and amounts are only included in revenue to the extent that it is probable that a significant reversal of cumulative revenue will not occur once any uncertainty is resolved. The assumptions for historical MLR, IBNR completion factor and constraint percentages were used by management in applying the most likely method. Under capitated arrangements with certain HMOs APC participates in one or more shared risk arrangements relating to the provision of institutional services to enrollees (shared risk arrangements) and thus can earn additional revenue or incur losses based upon the enrollee utilization of institutional services. Shared risk capitation arrangements are entered into with certain health plans, which are administered by the health plan, where APC is responsible for rendering professional services, but the health plan does not enter into a capitation arrangement with a hospital and therefore the health plan retains the institutional risk. Shared risk deficits, if any, are not payable until and unless (and only to the extent of any) risk sharing surpluses are generated. At the termination of the HMO contract, any accumulated deficit will be extinguished. Risk pool settlements under arrangements with HMOs are recognized, using the most likely methodology, and only included in revenue to the extent that it is probable that a significant reversal of cumulative revenue will not occur. Given the lack of access to the health plans’ data and control over the members assigned to APC, the adjustments and/or the withheld amounts are unpredictable and as such APC’s risk share revenue is deemed to be fully constrained until APC is notified of the amount by the health plan. Risk pools for the prior contract years are generally final settled in the third or fourth quarter of the following year. In addition to risk-sharing revenues, the Company also receives incentives under “pay-for-performance” programs for quality medical care, based on various criteria. As an incentive to control enrollee utilization and to promote quality care, certain HMOs have designed the quality incentive programs and commercial generic pharmacy incentive programs to compensate the Company for efforts it takes to improve the quality of services and for efficient and effective use of pharmacy supplemental benefits provided to the HMO’s members. The incentive programs track specific performance measures and calculate payments to the Company based on the performance measures. Incentives earned under “pay-for-performance” programs are recognized using the most likely methodology. However, as the Company does not have sufficient insight from the health plans on the amount and timing of the shared risk pool and incentive payments, these amounts are considered to be fully constrained and only recorded when such payments are known and/or received. Generally, for the foregoing arrangements, the final settlement is dependent on each distinct day’s performance within the annual measurement period but cannot be allocated to specific days until the full measurement period has occurred and performance can be assessed. As such, this is a form of variable consideration estimated at contract inception and updated through the measurement period (i.e. the contract year), to the extent the risk of reversal does not exist and the consideration is not constrained. NGACO AIPBP Revenue APAACO and CMS entered into a Next Generation ACO Model Participation Agreement (the “Participation Agreement”) with an initial term of two performance years through December 31, 2018, which has been extended for another two renewal years. For each performance year, the Company shall submit to CMS its selections for risk arrangement; the amount of the profit/loss cap; alternative payment mechanism; benefits enhancements, if any; and its decision regarding voluntary alignment under the NGACO Model. The Company must obtain CMS consent before voluntarily discontinuing any benefit enhancement during a performance year. Under the NGACO Model, CMS aligns beneficiaries to the Company to manage (direct care and pay providers) based on a budgetary benchmark established with CMS. The Company is responsible for managing medical costs for these beneficiaries. The beneficiaries will receive services from physicians and other medical service providers that are both in-network and out-of-network. The Company receives capitation from CMS on a monthly basis to pay claims from in-network providers. The Company records such capitation received from CMS as revenue as the Company is primarily responsible and liable for managing the patient care and for satisfying provider obligations, is assuming the credit risk for the services provided by in-network providers through its arrangement with CMS, and has control of the funds, the services provided and the process by which the providers are ultimately paid. Claims from out-of-network providers are processed and paid by CMS and the Company’s shared savings or losses in managing the services provided by out-of-network providers are generally determined on an annual basis after reconciliation with CMS. Pursuant to the Company’s risk share agreement with CMS, the Company will be eligible to receive the savings or be liable for the deficit according to the budget established by CMS based on the Company’s efficiency or lack thereof, respectively, in managing how the beneficiaries aligned to the Company by CMS are served by in-network and out-of-network providers. The Company’s savings or losses on providing such services are both capped by CMS, and are subject to significant estimation risk, whereby payments can vary significantly depending upon certain patient characteristics and other variable factors. Accordingly, the Company recognizes such surplus or deficit upon substantial completion of reconciliation and determination of the amounts. The Company records NGACO capitation revenues monthly, as that is when the Company is obligated to provide services to its members. Excess, over claims paid plus an estimate for the related IBNR (see Note 7), monthly capitation received are deferred and recorded as a liability until actual claims are paid or incurred. CMS will determine if there were any excess capitation paid for the performance year and the excess is refunded to CMS. Further, in accordance with the guidance in ASC 606-10-55-36 through 55-40 on principal versus agent considerations, the Company records such revenues in the gross amount of consideration. For each performance year, CMS shall pay the Company in accordance with the alternative payment mechanism, if any, for which CMS has approved the Company; the risk arrangement for which the Company has been approved by CMS; and as otherwise provided in the Participation Agreement. Following the end of each performance year and at such other times as may be required under the Participation Agreement, CMS will issue a settlement report to the Company setting forth the amount of any shared savings or shared losses and the amount of other monies. If CMS owes the Company shared savings or other monies, CMS shall pay the Company in full within 30 days after the date on which the relevant settlement report is deemed final, except as provided in the Participation Agreement. If the Company owes CMS shared losses or other monies owed as a result of a final settlement, the Company shall pay CMS in full within 30 days after the relevant settlement report is deemed final. If the Company fails to pay the amounts due to CMS in full within 30 days after the date of a demand letter or settlement report, CMS shall assess simple interest on the unpaid balance at the rate applicable to other Medicare debts under current provisions of law and applicable regulations. In addition, CMS and the U.S. Department of the Treasury may use any applicable debt collection tools available to collect any amounts owed by the Company. The Company participates in the AIPBP track of the NGACO Model. Under the AIPBP track, CMS estimates the total annual expenditures for APAACO’s assigned patients and pays that projected amount to the Company in monthly installments, and the Company is responsible for all Part A and Part B costs for in-network participating providers and preferred providers contracted by the Company to provide services to the assigned patients. As APAACO does not have sufficient insight into the financial performance of the shared risk pool with CMS because of unknown factors related to IBNR, risk adjustment factors, stop loss provisions, among other factors, an estimate cannot be developed. Due to these limitations, APAACO cannot determine the amount of surplus or deficit that will probably not be reversed in the future and therefore this shared risk pool revenue is considered fully constrained. For performance yea

Intangible Assets, Net

Intangible Assets, Net	3 Months Ended
	Mar. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets, Net	3. Intangible Assets, Net At March 31, 2019, the Company’s intangible assets, net, consisted of the following: Useful Gross Net Life March 31, Accumulated March 31, (Years) 2019 Amortization 2019 Indefinite Lived Assets: Medicare license N/A $ 1,994,000 $ - $ 1,994,000 Amortized Intangible Assets: Network relationships 11 15 109,883,000 (51,215,352 ) 58,667,648 Management contracts 15 22,832,000 (8,031,971 ) 14,800,029 Member relationships 12 6,696,000 (1,555,286 ) 5,140,714 Patient management platform 5 2,060,000 (549,333 ) 1,510,667 Tradename/trademarks 20 1,011,000 (67,400 ) 943,600 $ 144,476,000 $ (61,419,342 ) $ 83,056,658 At December 31, 2018, the Company’s intangible assets, net, consisted of the following: Useful Gross Net Life December 31, Accumulated December 31, (Years) 2018 Amortization 2018 Indefinite Lived Assets: Medicare license N/A $ 1,994,000 $ - $ 1,994,000 Amortized Intangible Assets: Network relationships 11 15 109,883,000 (48,361,773 ) 61,521,227 Management contracts 15 22,832,000 (7,447,581 ) 15,384,419 Member relationships 12 6,696,000 (1,289,667 ) 5,406,333 Patient management platform 5 2,060,000 (446,333 ) 1,613,667 Tradename/trademarks 20 1,011,000 (54,763 ) 956,237 $ 144,476,000 $ (57,600,117 ) $ 86,875,883 Included in depreciation and amortization on the accompanying condensed consolidated statements of income is amortization expense of $3.9 million and $4.4 million (excluding $0.1 million of amortization expense for exclusivity incentives) for the three months ended March 31, 2019 and 2018, respectively. Future amortization expense is estimated to be as follows for the years ending December 31: Amount 2019 (excluding the three months ended March 31, 2019) $ 10,661,000 2020 12,671,000 2021 10,960,000 2022 9,448,000 2023 7,790,000 Thereafter 29,532,000 $ 81,062,000

Investments in Other Entities

Investments in Other Entities	3 Months Ended
	Mar. 31, 2019
Equity Method Investments and Joint Ventures [Abstract]
Investments in Other Entities	4. Investments in Other Entities Equity Method Investment Summary Investments in other entities – equity method consisted of the following: March 31, 2019 December 31, 2018 Universal Care, Inc. $ 3,673,132 $ 2,635,945 LaSalle Medical Associates – IPA Line of Business 5,980,923 7,054,888 Diagnostic Medical Group 2,481,166 2,257,346 Pacific Medical Imaging & Oncology Center, Inc. 1,429,960 1,359,494 Pacific Ambulatory Surgery Center, LLC - 285,198 Accountable Health Care IPA- related party 4,202,958 4,977,957 531 W. College, LLC – related party 16,226,184 16,273,152 MWN, LLC – related party 33,000 33,000 $ 34,027,323 $ 34,876,980 LaSalle Medical Associates LaSalle Medical Associates (“LMA”) was founded by Dr. Albert Arteaga in 1996 and currently operates four neighborhood medical centers employing more than 120 dedicated healthcare professionals, treating children, adults and seniors in San Bernardino County. LMA’s patients are primarily served by Medi-Cal. LMA accepts Blue Cross, Blue Shield, Molina, Care 1 st LMA’s summarized balance sheets at March 31, 2019 and December 31, 2018 and summarized statements of operations for the three months ended March 31, 2019 and 2018 with respect to its IPA line of business are as follows: Balance Sheets March 31, 2019 December 31, 2018 Assets Cash and cash equivalents $ 204,981 $ 18,444,702 Receivables, net 7,116,487 2,897,337 Other current assets 3,526,319 5,459,442 Loan receivable 2,250,000 1,250,000 Restricted cash 673,204 667,414 Total assets $ 13,770,991 $ 28,718,895 Liabilities and Stockholders’ (Deficit) Equity March 31, 2019 December 31, 2018 Current liabilities $ 16,185,769 $ 26,837,814 Stockholders’ (deficit) equity (2,414,778 ) 1,881,081 Total liabilities and stockholders’ (deficit) equity $ 13,770,991 $ 28,718,895 Statements of Operations Three Months Ended March 31, 2019 Three Months Ended March 31, 2018 Revenues $ 46,406,351 $ 52,983,791 Expenses 50,702,210 54,002,458 Net loss $ (4,295,859 ) $ (1,018,667 ) Pacific Medical Imaging and Oncology Center, Inc. PMIOC was incorporated in 2004 in the state of California. PMIOC provides comprehensive diagnostic imaging services using state-of-the-art technology. PMIOC offers high quality diagnostic services such as MRI/MRA, PET/CT, CT, nuclear medicine, ultrasound, digital x-rays, bone densitometry and digital mammography at its facilities. In July 2015, APC-LSMA and PMIOC entered into a share purchase agreement whereby APC-LSMA invested $1.2 million for a 40% ownership in PMIOC. APC and PMIOC have an Ancillary Service Contract together whereby PMIOC provides covered services on behalf of APC to enrollees of the plans of APC. Under the Ancillary Service Contract, APC paid PMIOC fees for the three months ended March 31, 2019 and 2018 of approximately $0.7 million and $0.4 million, respectively. APC accounts for its investment in PMIOC under the equity method of accounting as APC has the ability to exercise significant influence, but not control over PMIOC’s operations. During the three months ended March 31, 2019 and 2018, APC recorded income (loss) from this investment of approximately $70,466 and $(26,025) respectively, in the accompanying condensed consolidated statements of income. The accompanying condensed consolidated balance sheets include the related investment balance of $1.4 million at March 31, 2019 and December 31, 2018. Universal Care, Inc. UCI is a privately held health plan that has been in operation since 1985 in order to help its members through the complexities of the healthcare system. UCI holds a license under the California Knox-Keene Health Care Services Plan Act (“Knox-Keene Act”) to operate as a full-service health plan. UCI contracts with CMS under the Medicare Advantage Prescription Drug Program. On August 10, 2015, UCAP, an entity solely owned 100% by APC with APC’s executives, Dr. Thomas Lam, Dr. Pen Lee and Dr. Kenneth Sim, as designated managers of UCAP, purchased from UCI 100,000 shares of UCI class A-2 voting common stock (comprising 48.9% of the total outstanding UCI shares, but 50% of UCI’s voting common stock) for $10.0 million. APC accounts for its investment in UCI under the equity method of accounting as APC has the ability to exercise significant influence, but not control over UCI’s operations. During the three months ended March 31, 2019 and 2018, the Company recorded income (loss) from this investment of approximately $1.0 million and $(20,202), respectively, in the accompanying condensed consolidated statements of income. The accompanying condensed consolidated balance sheets include the related investment balance of $3.6 million and $2.6 million at March 31, 2019 and December 31, 2018, respectively. UCI’s balance sheets at March 31, 2019 and December 31, 2018 and statements of income for the three months ended March 31, 2019 and 2018 are as follows: Balance Sheets March 31, 2019 December 31, 2018 Assets Cash $ 29,161,538 $ 27,812,520 Receivables, net 49,693,015 46,978,703 Other current assets 32,487,216 18,670,350 Other assets 659,897 661,621 Property and equipment, net 2,943,466 2,786,996 Total assets $ 114,945,132 $ 96,910,190 Liabilities and Stockholders’ Deficit March 31, 2019 December 31, 2018 Current liabilities $ 104,980,771 $ 89,731,133 Other liabilities 25,014,826 25,024,043 Stockholders’ deficit (15,050,465 ) (17,844,986 ) Total liabilities and stockholders’ deficit $ 114,945,132 $ 96,910,190 Statements of Income Three Months Ended March 31, 2019 Three Months Ended March 31, 2018 Revenues $ 113,318,827 $ 72,665,437 Expenses 111,408,456 72,154,950 Income before (benefit from) provision for income taxes 1,910,371 510,487 (Benefit from) provision for income taxes (210,667 ) 551,800 Net income (loss) $ 2,121,038 $ (41,313 ) Accountable Health Care, IPA – Related Party Accountable Health Care IPA (“Accountable”) is a California professional medical corporation that has served the local community in the greater Los Angeles County area through a network of physicians and health care providers for more than 20 years. Accountable currently has a network of over 400 primary and 700 specialty care physicians, and eight community and regional hospital medical centers that provide quality health care services to more than 160,000 members of seven federally qualified health plans and multiple product lines, including Medi-Cal, Commercial, Medicare and Healthy Families. On September 21, 2018, APC and NMM each exercised their option to convert their respective $5.0 million loans into shares of Accountable capital stock (see Note 6). As a result, APC’s $5.0 million loan was converted into a 25% equity interest with the remaining $5.0 million loan held by NMM to be converted into an equity interest that will be determined based on a third party valuation of Accountable’s current enterprise value, which has not been completed as of the filing of this Report. APC accounts for its investment in Accountable under the equity method of accounting. During the three months ended March 31, 2019, the Company recorded losses from this investment of $0.8 million in the accompanying condensed consolidated statements of income. The accompanying condensed consolidated balance sheets include the related investment balance of $4.2 million and $5.0 million at March 31, 2019 and December 31, 2018, respectively. Accountable’s balance sheet at March 31, 2019 and December 31, 2018 and statements of operations for the three months ended March 31, 2019 are as follows: Balance Sheets March 31, 2019 December 31, 2018 Assets Cash $ 4,381,055 $ 5,582,837 Receivables, net 11,246,477 11,246,477 Other current assets 30,940 30,940 Other assets 1,312,769 1,312,768 Property and equipment, net 138,690 138,690 Total Assets $ 17,109,931 $ 18,311,712 Liabilities and Stockholders’ Deficit March 31, 2019 December 31, 2018 Current Liabilities $ 18,723,556 $ 16,824,083 Other Liabilities 19,500,000 19,500,000 Stockholders’ deficit (21,113,625 ) (18,012,371 ) Total liabilities and stockholders’ deficit $ 17,109,931 $ 18,311,712 Statement of Operation Three Months Ended March 31, 2019 Revenues $ 22,990,290 Expenses 26,091,544 Loss before provision for income taxes (3,101,254 ) Provision for income taxes - Net loss* $ (3,101,254 ) * APC’s allocation of net loss commenced on September 21, 2018. Diagnostic Medical Group On May 14, 2016, David C.P. Chen M.D., Inc., a California professional corporation doing business as Diagnostic Medical Group (“DMG”), and David C.P. Chen M.D., individually and APC-LSMA, a designated shareholder professional corporation formed on October 15, 2012, which is 100% owned by Dr. Thomas Lam (CEO of APC) and is controlled and consolidated by APC who is the primary beneficiary of this VIE, entered into a share purchase agreement whereby APC-LSMA acquired a 40% ownership interest in DMG for total cash consideration of $1.6 million. APC accounts for its investment in DMG under the equity method of accounting as APC has the ability to exercise significant influence, but not control over DMG’s operations. For the three months ended March 31, 2019 and 2018, APC recorded income from this investment of $0.2 million and $0.3 million, respectively, in the condensed consolidated statements of income. The accompanying condensed consolidated balance sheets include the related investment balance of $2.5 million and $2.3 million as of March 31, 2019 and December 31, 2018, respectively. Pacific Ambulatory Surgery Center, LLC PASC, a California limited liability company, is a multi-specialty outpatient surgery center that is certified to participate in the Medicare program and is accredited by the Accreditation Association for Ambulatory Health Care. PASC has entered into agreements with organizations such as healthcare service plans, independent physician practice associations, medical groups and other purchasers of healthcare services for the arrangement of the provision of outpatient surgery center services to subscribers or enrollees of such health plans. On November 15, 2016, PASC and APC, entered into a membership interest purchase agreement whereby PASC sold 40% of its aggregate issued and outstanding membership interests to APC for total consideration of $0.8 million. In connection with the membership interest purchase agreement, PASC entered into a management services agreement with NMM, which requires the payment of management fees computed at predetermined percentage (as defined) of PASC revenues. The term of the management services agreement commenced on the effective date and extend for a period of 60 months thereafter, and may be extended in writing at the sole option of NMM for an additional period of 60 months following the expiration of the initial term and is automatically renewed for additional consecutive terms of three years unless terminated by either party. PASC shall not be permitted to terminate the management services agreement for any reason during the initial term and, if extended, the extended term. APC accounted for its investment in PASC under the equity method of accounting as APC has the ability to exercise significant influence, but not control over PASC’s operations. For the three months ended March 31, 2018, APC recorded income from this investment of $41,953 in the accompanying condensed consolidated statements of income. The accompanying condensed consolidated balance sheets include the related investment balance of $0.3 million as of December 31, 2018. During the three months ended March 31, 2019, the Company recognized an impairment loss of $0.3 million, which has been included in the loss from equity method investment line on the condensed consolidated statement of income, related to its investment in PASC as the Company does not believe it will recover its investment balance. In 2019, APC advanced $0.3 million to PASC for working capital purposes. The repayment of the advance is based on collections of PASC’s outstanding AR, and accordingly, the entire amount has been classified under “Other Assets” in the accompanying condensed consolidated balance sheets in the amount of $0.3 million as of March 31, 2019. 531 W. College LLC – Related Party In June 2018, College Street Investment LP, a California limited partnership (“CSI”), APC and NMM entered into an operating agreement to govern the limited liability company, 531 W. College, LLC and the conduct of its business, and to specify their relative rights and obligations. CSI, APC and NMM, each owns 50%, 25% and 25%, respectively, of member units based on initial capital contributions of $16.7 million, $8.3 million, and $8.3 million, respectively. An agreement of purchase and sale and joint escrow instructions (“Purchase Agreement”) with an effective date of April 10, 2018 was entered into between 531 W. College, LLC and Societe Francaise De Bienfaisance Mutuelle De Los Angeles, a California nonprofit corporation, pursuant to which 531 W. College LLC agreed to purchase a former hospital located in the City of Los Angeles. The total purchase price of such real estate is $33.3 million. In June 2018, APC, NMM and AMHC Healthcare, Inc. on behalf of CSI, wired $8.3 million, $8.3 million and $16.7 million, respectively into an escrow account for the benefit of 531 W. College, LLC to purchase the hospital pursuant to the Purchase Agreement. The transaction closed on June 29, 2018. APC and NMM accounts for its investment in 531 W. College, LLC under the equity method of accounting as APC and NMM have the ability to exercise significant influence, but not control over the operations of this joint venture. APC and NMM’s investment is presented as an investment in joint venture-equity method in the accompanying condensed consolidated balance sheet as of March 31, 2019 and December 31, 2018. As of March 31, 2019, NMM and APC has recorded losses from its investment in 531 W. College LLC of $23,484, respectively, in the accompanying condensed consolidated statement of income. The accompanying condensed consolidated balance sheet includes the related investment balance of $16.2 million related to NMM and APC’s investment at March 31, 2019. 531 W. College LLC’s balance sheets at March 31, 2019 and December 31, 2018 and the statements of operations for the three months ended March 31, 2019 is as follows: Balance Sheet March 31, 2019 December 31, 2018 Assets Cash 341,969 158,088 Other current assets 78,677 16,137 Other assets 70,000 70,000 Property and equipment, net $ 33,394,792 $ 33,394,792 Total assets $ 33,885,438 $ 33,639,017 Liabilities and Members’ Equity Current liabilities $ 1,433,070 $ 1,007,413 Stockholders’ equity 32,452,368 32,631,604 Total liabilities and members’ equity $ 33,885,438 $ 33,639,017 Statements of Operation March 31, 2019 Revenues - Expenses 468,560 Loss from operations (468,560 ) Other Income $ 289,325 Net loss* $ (179,235 ) * The Company’s investment in 531 W. College commenced on June 27, 2018. MWN LLC – Related Party On December 18, 2018, NMM along with 6 Founders LLC, a California limited liability company doing business as Pacific6 Enterprises (“Pacific6”), and Health Source MSO Inc., a California corporation (“HSMSO”) entered into an operating agreement to govern MWN Community Hospital, LLC and the conduct of its business and to specify their relative rights and obligations. NMM, Pacific6, and HSMSO each owns 33.3% of the membership shares based on each member’s initial capital contributions of $3,000 and working capital contributions of $30,000. The accompanying condensed consolidated balance sheets include the related investment balance of $33,000 as of March 31, 2019 and December 31, 2018, respectively. Investment in privately held entity that does not report net asset value per share In May 2018, APC purchased 270,000 membership interests of MediPortal LLC, a New York limited liability company, for $0.4 million or $1.50 per membership interest, which represented approximately 2.8% ownership. 5-year warrant to purchase 270,000 membership interests

Loan Receivable - Related Parti

Loan Receivable - Related Parties	3 Months Ended
	Mar. 31, 2019
Loan Receivable [Abstract]
Loan Receivable – Related Parties	5. Loan Receivable – Related Parties Accountable Health Care IPA On October 9, 2017, NMM and APC-LSMA entered into an agreement with Accountable, Signal Health Solutions, Inc. (“Signal”), a California corporation and George M. Jayatilaka, M.D. (“Dr. Jay”), individually, whereby concurrent with the execution of the agreement, APC-LSMA extended a line of credit to Dr. Jay in the principal amount of $10.0 million (“Dr. Jay Loan”) to fund the working capital needs of Accountable ($5.0 million of which was funded by APC on behalf of APC-LSMA and the other $5.0 million was funded by NMM to Dr. Jay). Interest on the Dr. Jay Loan accrues at a rate that is equal to the prime rate plus 1% (6.50% as of March 31, 2019 and December 31, 2018) and payable in monthly installments of interest only on the first day of each month until the date that is three years following the initial date of funding, at which time, all outstanding principal and accrued interest thereon shall be due and payable in full. The Dr. Jay Loan is not subordinated to any other indebtedness and is secured by a first-lien security interest in certain shares of Accountable owned by Dr. Jay. The outstanding balance as of March 31, 2019 and December 31, 2018 was $5.0 million and $5.0 million, respectively. Concurrently with the funding of the Dr. Jay Loan, Dr. Jay loaned to Accountable the entire proceeds of the Dr. Jay Loan at the same interest rate and maturity date as the Dr. Jay Loan (“Dr. Jay-Accountable Subordinated Loan”). Repayment of the Dr. Jay-Accountable Subordinated Loan is subordinated to Accountable’s creditors in a manner acceptable to the California Department of Managed Health Care (“DMHC”). At any time on or before the date that is one year following the initial funding date of the Dr. Jay Loan, APC-LSMA or its designee have the right, but not the obligation, to convert up to $5.0 million of the outstanding principal amount into shares of Accountable’s capital stock. At any time after the date that is one year following the funding date, the Dr. Jay Loan may be prepaid at any time. Within three years following the initial funding of the Dr. Jay Loan, APC-LSMA or its designee shall have the right, but not the obligation, to convert the then outstanding principal amount into Accountable shares based on Accountable’s then-current valuation. On September 21, 2018, APC and NMM each exercised their option to convert their respective $5.0 million loan into shares of Accountable capital stock. As a result, APC’s $5.0 million loan was converted into a 25% equity interest with the remaining $5.0 million loan held by NMM to be converted into an equity interest that will be determined based on a third party valuation of Accountable’s current enterprise value, which has not been completed as of the filing date of this Report. APC accounted for its investment in Accountable under the equity method of accounting (See Note 4). Subsequent to the funding of the Dr. Jay Loan, to the extent needed by Accountable for working capital needs as determined by APC-LSMA, APC-LSMA will extend an additional line of credit in the principal amount up to $8.0 million. The funding mechanism, interest rate and maturity date of such additional line of credit shall be the same as the Dr. Jay Loan and additional collateral security in Accountable’s issued and outstanding shares will be required. As a condition of funding the Dr. Jay Loan, Accountable entered into a ten-year management service agreement with NMM on October 27, 2017, to commence on the termination of Accountable’s previously existing management agreement with MedPoint Management to be effective on December 1, 2017. Under the management service agreement, NMM is responsible for managing 100% of all health plan membership assigned and delegated to Accountable, and all hospital risk pools. The management service agreement requires the payment of IPA and hospital risk pool management fees as set forth therein. Concurrent with the initial funding of the Dr. Jay Loan, the Accountable Board of Directors shall be automatically reconstituted to be comprised of two directors, which will comprise of Dr. Jay and a director appointed by APC-LSMA. Dr. Jay and APC-LSMA will have two and one votes as a director, respectively. Based on management’s assessment, Accountable is a variable interest entity. However, the Company does not have the power to the direct the activities of Accountable that most significantly impact its economic performance and as such, the Company is not the primary beneficiary of Accountable. Universal Care, Inc. In 2015, APC advanced $5.0 million on behalf of UCAP to UCI for working capital purposes. On June 29, 2018, and November 28, 2018, APC advanced an additional $2.5 million and $5.0 million, respectively. These subordinated loans accrue interest at the prime rate plus 1%, or 6.50%, as of March 31, 2019 and December 31, 2018, with interest to be paid monthly. The repayment schedule is based on certain contingent criteria, and accordingly, the entire note receivable has been classified under loans receivable - related parties on the condensed consolidated balance sheets in the amount of $12.5 million as of March 31, 2019 and December 31, 2018.

Accounts Payable and Accrued Ex

Accounts Payable and Accrued Expenses	3 Months Ended
	Mar. 31, 2019
Payables and Accruals [Abstract]
Accounts Payable and Accrued Expenses	6. Accounts Payable and Accrued Expenses The Company’s accounts payable and accrued expenses consisted of the following: March 31, 2019 December 31, 2018 Accounts payable $ 4,750,543 $ 4,481,544 Specialty capitation payable 300,000 300,000 Subcontractor IPA risk pool payable 2,191,664 2,532,750 Professional fees 2,470,583 2,251,741 Due to related parties 568,385 1,488,313 Contract liabilities 33,292,123 9,024,235 Accrued compensation 4,081,173 4,996,906 $ 47,654,471 $ 25,075,489

Medical Liabilities

Medical Liabilities	3 Months Ended
	Mar. 31, 2019
Disclosure of Medical Liabilities [Abstract]
Medical Liabilities	7. Medical Liabilities The Company’s medical liabilities consisted of the following: March 31, 2019 December 31, 2018 Balance, beginning of period $ 33,641,701 $ 63,972,318 Claims paid for previous period (28,850,325 ) (36,549,348 ) Incurred health care costs 34,974,952 209,002,961 Claims paid for current period (16,586,584 ) (167,537,480 ) Payment to CMS based on APAACO 2017 year settlement - (34,464,826 ) Adjustments 86,121 (781,924 ) Balance, end of period $ 23,265,865 $ 33,641,701

Bank Loan and Lines of Credit

Bank Loan and Lines of Credit	3 Months Ended
	Mar. 31, 2019
Disclosure of Bank Loan and Lines of Credit [Abstract]
Bank Loan and Lines Of Credit	8. Bank Loan and Lines of Credit Bank Loans In December 2010, ICC obtained a loan of $4.6 million from a financial institution. The loan bears interest based on the Wall Street Journal “prime rate”, or 5.50% per annum, as of December 31, 2018. The loan was collateralized by the medical equipment ICC owns and guaranteed by one of ICC’s shareholders. The loan matured on December 31, 2018 and final payment was made in January 2019. Lines of Credit – Related Party On June 14, 2018, NMM amended its promissory note agreement with Preferred Bank (“NMM Business Loan Agreement”), which provides for loan availability of up to $20.0 million with a maturity date of June 22, 2020. One of the Company’s board members is the chairman and CEO of Preferred Bank. The NMM Business Loan Agreement was subsequently amended on September 1, 2018 to temporarily increase the loan availability from $20.0 million to $27.0 million for the period from September 1, 2018 through January 31, 2019, further extended to October 31, 2019, pursuant to an amendment entered into March 5, 2019 to facilitate the issuance of an additional standby letter of credit for the benefit of CMS. The interest rate is based on the Wall Street Journal “prime rate” plus 0.125%, or 5.625%, as of March 31, 2019 and December 31, 2018. As of March 31, 2019, NMM was in compliance with such financial debt covenant requirements. The loan is guaranteed by Apollo Medical Holdings, Inc. and is collateralized by substantially all of the assets of NMM. The amount outstanding as of March 31, 2019 and December 31, 2018 was $13.0 million. As of March 31, 2019 and December 31, 2018, availability under this line of credit was $0.7 million. On September 5, 2018, NMM entered into a non-revolving line of credit agreement with Preferred Bank (“NMM Line of Credit Agreement”), which provides for loan availability of up to $20.0 million with a maturity date of September 5, 2019 On June 14, 2018, APC amended its promissory note agreement with Preferred Bank (“APC Business Loan Agreement”), which provides for loan availability of up to $10.0 million with a maturity date of June 22, 2020 Standby Letters of Credit On March 3, 2017, APAACO established an irrevocable standby letter of credit with Preferred Bank (through the NMM Business Loan Agreement) for $6.7 million for the benefit of CMS. The letter of credit expired on December 31, 2018 and was deemed automatically extended without amendment for additional one - year periods from the present or any future expiration date, unless notified by the institution to terminate prior to 90 days from any expiration date. APAACO may continue to draw from the letter of credit for one year following the bank’s notification of non-renewal. On October 3, 2018, APAACO established a second irrevocable standby letter of credit with Preferred Bank (through the NMM Business Loan Agreement) for $6.6 million for the benefit of CMS. The letter of credit expires on December 31, 2019 and is deemed automatically extended without amendment for additional one - year periods from the present or any future expiration date, unless notified by the institution to terminate prior to 90 days from any expiration date. APC established irrevocable standby letters of credit with a financial institution for a total of $0.3 million for the benefit of certain health plans. The standby letters of credit are automatically extended without amendment for additional one-year periods from the present or any future expiration date, unless notified by the institution in advance of the expiration date that the letter will be terminated.

Mezzanine and Stockholders' Equ

Mezzanine and Stockholders' Equity	3 Months Ended
	Mar. 31, 2019
Stockholders' Equity Note [Abstract]
Mezzanine and Stockholders' Equity	9. Mezzanine and Stockholders’ Equity Mezzanine APC APC’s shareholders have entered into shareholder agreements that requires APC, under the circumstances described in those agreements, to repurchase the APC shares from the shareholders. Since the redemption feature (see Note 2) of the shares is not solely within the control of APC, the equity of APC does not qualify as permanent equity and has been classified as noncontrolling interests in mezzanine or temporary equity. Except when the repurchase obligation is triggered, APC’s shares are not redeemable and it is not probable that the shares will become redeemable as of March 31, 2019 and December 31, 2018. On December 18, 2018, the Company entered into a settlement agreement and mutual release with former APCN shareholders to repurchase all the equity interests in APC previously held by these shareholders. APC paid approximately $1.7 million to repurchase 1,662,571 shares of common stock (see Note 10). Stockholders’ Equity As of the date of this Report, 480,212 holdback shares have not been issued to certain former NMM shareholders who were NMM shareholders at the time of Closing of the Merger, as they have yet to submit properly completed letters of transmittal to ApolloMed in order to receive their pro rata portion of ApolloMed common stock and warrants as contemplated under the Merger Agreement. Pending such receipt, such former NMM shareholders have the right to receive, without interest, their pro rata share of dividends or distributions with a record date after the effectiveness of the Merger. The condensed consolidated financial statements have treated such shares of common stock as outstanding, given the receipt of the letter of transmittal is considered perfunctory and the Company is legally obligated to issue these shares in connection with the Merger. See options and warrants section below for common stock issued upon exercise of stock options and stock purchase warrants. Options The Company’s outstanding stock options consisted of the following: Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (in millions) Options outstanding at January 1, 2019 647,240 $ 5.62 4.13 $ 9.2 Options granted 45,000 18.11 - - Options exercised (6,000 ) 4.50 - 0.1 Options forfeited - - - - Options outstanding at March 31, 2019 686,240 $ 6.45 3.95 $ 8.1 Options exercisable at March 31, 2019 641,240 $ 5.27 3.64 $ 8.1 During the three months ended March 31, 2019 and 2018, stock options were exercised for 6,000 and 75,000 shares, respectively, of the Company’s common stock, which resulted in proceeds of approximately $27,000 and $0.5 million, respectively. The exercise price was $4.50 per share for the exercises during the three months ended March 31, 2019 and ranged from $2.10 to $10.00 per share for the exercises during the three months ended March 31, 2018. During the three months ended March 31, 2018, stock options were exercised pursuant to the cashless exercise provision of the option agreement, with respect to 54,536 shares of the Company’s common stock, which resulted in the Company issuing 43,201 net shares. During the three months ended March 31, 2019, the Company granted 45,000 stock options to certain ApolloMed board members which were recognized at fair value, as determined using the Black-Scholes option pricing model and the following assumptions: March 31, 2019 Expected Term 3.0 Expected volatility 100.27 Risk-free interest rate 2.51 Market value of common stock $ 18.11 Annual dividend yield - Forfeiture rate 0 % During the three months ended March 31, 2019, the Company recorded approximately $0.1 million of share-based compensation expense associated with the issuance of restricted shares of common stock and vesting of stock options Outstanding stock options granted to primary care physicians to purchase shares of APC’s common stock consisted of the following: Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (in millions) Options outstanding at January 1, 2019 853,800 $ 0.167 0.75 $ 0.5 Options granted - - - - Options exercised - - - - Options expired/forfeited - - - - Options outstanding and exercisable at March 31, 2019 853,800 $ 0.167 0.50 $ 0.5 The aggregate intrinsic value is calculated as the difference between the exercise price and the estimated fair value of common stock as of March 31, 2019. Share-based compensation expense related to option awards granted to primary care physicians to purchase shares of APC’s common stock, are recognized over their respective vesting periods, and consisted of the following: Three Months Ended March 31, 2019 2018 Share-based compensation expense: General and administrative $ 202,382 $ 202,382 $ 202,382 $ 202,382 The remaining unrecognized share-based compensation expense of stock option awards granted to primary care physicians to purchase shares of APC’s common stock as of March 31, 2019 was $0.4 million which is expected to be recognized over the remaining term of 0.5 years. Warrants The Company’s outstanding warrants consisted of the following: Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (in millions) Warrants outstanding at January 1, 2019 3,331,995 $ 9.93 2.97 $ 33.1 Warrants granted - - - - Warrants exercised (11,516 ) 9.81 - 0.1 Warrants expired/forfeited - - - - Warrants outstanding at March 31, 2019 3,320,479 $ 9.93 2.72 $ 27.9 Weighted Weighted Average Average Exercise Price Exercise Price Per Warrants Remaining Warrants Per Share Outstanding Contractual Life Exercisable Share $ 9.00 1,075,492 1.54 1,075,492 9.00 10.00 1,416,085 3.04 1,416,085 10.00 11.00 828,902 3.69 828,902 11.00 $ 9.00 –11.00 3,320,479 2.72 3,320,479 $ 9.93 During the three months ended March 31, 2019, common stock warrants were exercised for 11,516 shares of the Company’s common stock, which resulted in proceeds of approximately $0.1 million. The exercise price ranged from $9.00 to $11.00 per share. Treasury Stock APC owned 1,775,561 and 1,682,110 shares of ApolloMed’s common stock as of March 31, 2019 and December 31, 2018, which are legally issued and outstanding but excluded from shares of common stock outstanding in the condensed consolidated financial statements, as such shares are treated as treasury shares for accounting purposes. Pursuant to the issuance of the Holdback Shares (see Note 13), 93,451 shares issued to APC are treated as treasury shares. The remaining treasury shares of 168,493 were repurchased from the former APCN shareholders in 2018. Dividends During the three months ended March 31, 2019 and 2018, APC paid dividends of $10.0 million and $2.0 million, respectively.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2019
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	10. Commitments and Contingencies Regulatory Matters Laws and regulations governing the Medicare program and healthcare generally are complex and subject to interpretation. The Company believes that it is in compliance with all applicable laws and regulations and is not aware of any pending or threatened investigations involving allegations of potential wrongdoing. While no regulatory inquiries have been made, compliance with such laws and regulations can be subject to future government review and interpretation as well as significant regulatory action including fines, penalties, and exclusion from the Medicare and Medi-Cal programs. As risk-bearing organizations, APC is required to follow regulations of the California DMHC, including maintenance of minimum working capital, tangible net equity (“TNE”), cash-to-claims ratio and claims payment requirements prescribed by the California DMHC. TNE is defined as net equity less intangibles, less non-allowable assets (which include unsecured amounts due from affiliates), plus subordinated obligations. At March 31, 2019 and December 31, 2018, APC was in compliance with these regulations. Many of the Company’s payor and provider contracts are complex in nature and may be subject to differing interpretations regarding amounts due for the provision of medical services. Such differing interpretations may not come to light until a substantial period of time has passed following contract implementation. Liabilities for claims disputes are recorded when the loss is probable and can be estimated. Any adjustments to reserves are reflected in current operations. Affordable Care Act The Patient Protection and Affordable Care Act (“PPACA”) has made significant changes to the United States health care system. The legislation impacted multiple aspects of the health care system, including many provisions that change payments from Medicare, Medicaid and insurance companies. Under this legislation, 33 states have expanded their Medicaid programs to cover previously uninsured childless adults, and four additional states voted in 2018 to expand Medicaid or to elect a governor that pledged to expand Medicaid. In addition, many uninsured individuals have had the opportunity to purchase health insurance via state-based marketplaces, state-based marketplaces using a federal platform, state-partnership marketplaces or the federally-facilitated marketplace. PPACA also implemented a number of health insurance market reforms, such as allowing children to remain on their parents’ health insurance until age 26 or prohibiting certain plans from denying coverage based on pre-existing conditions. Nationally, these reforms have reduced the number of uninsured individuals. It is unclear what changes may be made to PPACA with the divided Congress, current presidential administration, and pending litigation over the validity of PPACA. The Administration has promulgated rules to broaden the availability of coverage options that do not comply with the full range of PPACA requirements for individual market coverage, namely Association Health Plans and Short-Term Limited-Duration Insurance. The Administration has also provided additional guidance on state PPACA waivers. These executive actions have been or may be challenged in court. In addition, the Tax Cuts and Jobs Act (“TCJA”), passed in December 2017, eliminates the individual mandate penalty under PPACA, effective January 1, 2019. The individual mandate penalty was included in PPACA to address concerns that other market reforms expanding access to coverage might produce adverse selection and higher premiums. The extent to which the repeal of the individual mandate penalty will impact the uninsured rate and 2019 premiums is unclear at this juncture. On December 14, 2018, the United States District Court for the Northern District of Texas ruled that the individual mandate without the penalty is unconstitutional and that PPACA is therefore invalid in its entirety. Litigation on this issue is ongoing, with the Administration indicating it will continue implementing PPACA pending any appeals, the court ordering expedited briefing on a potential stay and certification of an interlocutory appeal, and pending litigation in the United States District Court for the District of Maryland to ensure continued implementation of PPACA. This litigation along with any future legislative changes to PPACA or other federal and state legislation could have a material impact on the operations of the Company. The Company is continuing to monitor the legislative environment and developments in pending litigation for risks and uncertainties. Standby Letters of Credit As part of the APAACO participation with CMS, the Company must provide a financial guarantee to CMS, the guarantee generally must be in an amount of 2% of our benchmark Medicare Part A and Part B expenditures. The Company has established irrevocable standby letters of credit with Preferred Bank, which is affiliated with one of the Company’s board members, of $6.6 million and $6.7 million for the 2018 and 2017 performance years, respectively (see Note 8). APC established irrevocable standby letters of credit with a financial institution for a total of $0.3 million for the benefit of certain health plans. The standby letters of credit are automatically extended without amendment for additional one-year periods from the present or any future expiration date, unless notified by the institution in advance of the expiration date that the letter will be terminated (see Note 8). Litigation From time to time, the Company is involved in various legal proceedings and other matters arising in the normal course of its business. The resolution of any claim or litigation is subject to inherent uncertainty and could have a material adverse effect on the Company’s financial condition, cash flows or results of operations. Prospect Medical Systems On or about March 23, 2018 and April 3, 2018, a Demand for Arbitration and an Amended Demand for Arbitration were filed by Prospect Medical Group, Inc. and Prospect Medical Systems, Inc. (collectively, “Prospect”) against MMG, ApolloMed and AMM with Judicial Arbitration Mediation Services in California, arising out of MMG’s purported business plans, seeking damages in excess of $5.0 million, and alleging breach of contract, violation of unfair competition laws, and tortious interference with Prospect’s current and future economic relationships with its health plans and their members. MMG, ApolloMed and AMM dispute the allegations and intend to vigorously defend against this matter. The resolution of this matter and any potential range of loss in excess of any current accrual cannot be reasonably determined or estimated at this time primarily because the matter has not been fully arbitrated and presents unique regulatory and contractual interpretation issues. Liability Insurance The Company believes that its insurance coverage is appropriate based upon the Company’s claims experience and the nature and risks of the Company’s business. In addition to the known incidents that have resulted in the assertion of claims, the Company cannot be certain that its insurance coverage will be adequate to cover liabilities arising out of claims asserted against the Company, the Company’s affiliated professional organizations or the Company’s affiliated hospitalists in the future where the outcomes of such claims are unfavorable. The Company believes that the ultimate resolution of all pending claims, including liabilities in excess of the Company’s insurance coverage, will not have a material adverse effect on the Company’s financial position, results of operations or cash flows; however, there can be no assurance that future claims will not have such a material adverse effect on the Company’s business. Contracted physicians are required to obtain their own insurance coverage. Although the Company currently maintains liability insurance policies on a claims-made basis, which are intended to cover malpractice liability and certain other claims, the coverage must be renewed annually, and may not continue to be available to the Company in future years at acceptable costs, and on favorable terms.

Related Party Transactions

Related Party Transactions	3 Months Ended
	Mar. 31, 2019
Related Party Transactions [Abstract]
Related Party Transactions	11. Related Party Transactions On November 16, 2015, UCAP entered into a subordinated note receivable agreement with UCI, a 48.9% owned equity method investee (See Note 4), in the amount of $5.0 million. On June 28, 2018 and November 28, 2018, UCAP entered into two additional subordinated note receivable agreements with UCI in the amount of $2.5 million and $5.0 million, respectively (see Note 5). During the three months ended March 31, 2019 and 2018, NMM received approximately $3.2 million and $4.6 million, respectively, in management fees from LMA, which is accounted for under the equity method based on 25% equity ownership interest held by APC in LMA’s IPA line of business (see Note 4). During the three months ended March 31, 2019 and 2018, APC paid approximately $0.7 million and $0.4 million, respectively, to PMIOC for provider services, which is accounted for under the equity method based on 40% equity ownership interest held by APC (see Note 4). During the three months ended March 31, 2019 and 2018, APC paid approximately $2.0 million and $1.6 million, respectively, to DMG for provider services, which is accounted for under the equity method based on 40% equity ownership interest held by APC (see Note 4). During the three months ended March 31, 2019 and 2018, APC paid approximately $92,000 and $22,000, respectively, to Advanced Diagnostic Surgery Center for services as a provider. Advanced Diagnostic Surgery Center shares common ownership with certain board members of APC. During the three months ended March 31, 2019 and 2018, APC paid approximately $1.3 million and $0.7 million, respectively, to AMG, Inc. for services as a provider. AMG, Inc. shares common ownership with certain board members of APC. During the three months ended March 31, 2019 and 2018, APC paid an aggregate of approximately $9.3 million and $9.2 million, respectively, to shareholders of APC for provider services, which include approximately $3.3 million and $2.3 million, respectively, to shareholders who are also officers of APC. During the three months ended March 31, 2019 and 2018, NMM paid approximately $0.3 million, to Medical Property Partners (“MPP”) for an office lease. MPP shares common ownership with certain board members of NMM. During the three months ended March 31, 2018, APC paid $90,000, to Tag-2 Medical Investment Group, LLC (“Tag-2”) for an office lease. Tag-2 shares common ownership with certain board members of APC. During the three months ended March 31, 2019 and 2018, the Company paid approximately $0.1 million and $35,000, respectively, to Critical Quality Management Corp (“CQMC”) for an office lease. CQMC shares common ownership with certain board members of APC. During the three months ended March 31, 2019 and 2018, SCHC paid approximately $0.1 million, respectively, to Numen, LLC (“Numen”) for an office lease. Numen is owned by a shareholder of APC. The Company has agreements with HSMSO, Aurion Corporation (“Aurion”), and AHMC Healthcare (“AHMC”) for services provided to the Company. One of the Company’s board members is an officer of AHMC, HSMSO and Aurion. Aurion is also partially owned by one of the Company’s board members. The following table sets forth fees incurred and income received related to AHMC, HSMSO and Aurion Corporation: Three months ended March 31, 2019 2018 AHMC – Risk pool and Capitation $ 11,600,000 $ 19,400,000 HSMSO – Management fees, net (650,000 ) (500,000 ) Aurion – Management fees (100,000 ) (100,000 ) Net total $ 10,850,000 $ 18,800,000 The Company and AHMC has a risk sharing agreement with certain AHMC hospitals to share the surplus and deficits of each of the hospital pools. During the three months ended March 31, 2019 and 2018, the Company has recognized risk pool revenue under this agreement of $10.1 million and $18.0 million respectively, for which $49.8 million and $44.2 million remain outstanding as of March 31, 2019 and December 31, 2018, respectively. In addition, affiliates wholly-owned by the Company’s officers, including our CEO, Dr. Lam, are reported in the accompanying condensed consolidated statement of income on a consolidated basis, together with the Company’s subsidiaries, and therefore, the Company does not separately disclose transactions between such affiliates and the Company’s subsidiaries as related party transactions. For equity method investments, loans receivable and line of credits from related parties, see Notes 4, 5 and 8, respectively.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	12. Income Taxes The Company uses the liability method of accounting for income taxes as set forth in ASC 740. Under the liability method, deferred taxes are determined based on differences between the financial statement and tax bases of assets and liabilities using enacted tax rates. On an interim basis, the Company estimates what its anticipated annual effective tax rate will be and records a quarterly income tax provision (benefit) in accordance with the estimated annual rate, plus the tax effect of certain discrete items that arise during the quarter. As the year progresses, the Company refines its estimates based on actual events and financial results during the quarter. This process can result in significant changes to the Company’s estimated effective tax rate. If and when this occurs, the income tax provision (benefit) will be adjusted during the quarter in which the estimates are refined so that the year-to-date provision reflects the estimated annual effective tax rate. These changes, along with adjustments to the Company’s deferred taxes and related valuation allowance, may create fluctuations in the Company’s overall effective tax rate from quarter to quarter. As of March 31, 2019 due to the overall cumulative losses incurred in recent years, the Company maintained a full valuation allowance against its deferred tax assets related to loss entities the Company cannot consolidate under the Federal consolidation rules, as realization of these assets is uncertain. The Company’s effective tax rate for the three months ended March 31, 2019 differed from the U.S. federal statutory rate primarily due to state income taxes, income from flow through entities, and change in valuation allowance. As of March 31, 2019, the Company does not have any unrecognized tax benefits related to various federal and state income tax matters. The Company will recognize accrued interest and penalties related to unrecognized tax benefits in income tax expense. The Company is subject to U.S. federal income tax as well as income tax in California. The Company and its subsidiaries’ state and Federal income tax returns are open to audit under the statute of limitations for the years ended December 31, 2014 through December 31, 2017 and for the years ended December 31, 2015 through December 31, 2017, respectively. The Company currently does not anticipate material unrecognized tax benefits within the next 12 months.

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2019
Earnings Per Share [Abstract]
Earnings Per Share	13. Earnings Per Share Basic net income per share is calculated using the weighted average number of shares of the Company’s common stock issued and outstanding during a certain period, and is calculated by dividing net income by the weighted average number of shares of the Company’s common stock issued and outstanding during such period. Diluted net income per share is calculated using the weighted average number of shares of common stock and potentially dilutive shares of common stock outstanding during the period, using the as-if converted method for secured convertible notes, preferred stock, and the treasury stock method for options and common stock warrants. Pursuant to the Merger Agreement, ApolloMed held back 10% of the shares of its common stock that were issuable to NMM shareholders (“Holdback Shares”) to secure indemnification of ApolloMed and its affiliates under the Merger Agreement. The Holdback Shares will be held for a period of up to 24 months, with 50% issued on the first anniversary of the merger and the remaining 50% issued on the second anniversary, after the closing of the Merger (to be distributed on a pro-rata basis to former NMM shareholders), during which ApolloMed may seek indemnification for any breach of, or noncompliance with, any provision of the Merger Agreement, by NMM. These Holdback Shares are excluded from the computation of basic earnings per share, but included in diluted earnings per share. As of March 31, 2019 and December 31, 2018 APC held 1,775,561 and 1,682,110 shares of ApolloMed’s and NMM’s common stock, respectively, which are treated as treasury shares for accounting purposes and not included in the number of shares of common stock outstanding used to calculate earnings per share. Below is a summary of the earnings per share computations: Three Months Ended March 31, 2019 2018 Earnings per share – basic $ 0.00 $ 0.07 Earnings per share – diluted $ 0.00 $ 0.06 Weighted average shares of common stock outstanding – basic 34,496,622 32,421,467 Weighted average shares of common stock outstanding – diluted 38,074,174 38,098,373 Below is a summary of the shares included in the diluted earnings per share computations: Three Months Ended March 31, 2019 2018 Weighted average shares of common stock outstanding – basic 34,496,622 32,421,467 10% shares held back pursuant to indemnification clause 1,519,805 3,039,749 Stock options 455,381 835,790 Warrants 1,602,366 1,801,367 Weighted average shares of common stock outstanding – diluted 38,074,174 38,098,373

Variable Interest Entities (VIE

Variable Interest Entities (VIEs)	3 Months Ended
	Mar. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Variable Interest Entities (VIEs)	14. Variable Interest Entities (VIEs) A VIE is defined as a legal entity whose equity owners do not have sufficient equity at risk, or, as a group, the holders of the equity investment at risk lack any of the following three characteristics: decision-making rights, the obligation to absorb losses, or the right to receive the expected residual returns of the entity. The primary beneficiary is identified as the variable interest holder that has both the power to direct the activities of the VIE that most significantly affect the entity’s economic performance and the obligation to absorb expected losses or the right to receive benefits from the entity that could potentially be significant to the VIE. The Company follows guidance on the consolidation of VIEs that requires companies to utilize a qualitative approach to determine whether it is the primary beneficiary of a VIE. See Note 2 – “Basis of Presentation and Summary of Significant Accounting Policies” to the accompanying condensed consolidated financial statements for information on how the Company determines VIEs and its treatment. The following table includes assets that can only be used to settle the liabilities of APC and the creditors of APC have no recourse to the Company, nor do creditors of the Company have recourse against the assets of APC. These assets and liabilities, with the exception of the investment in a privately held entity that does not report net asset value per share and amounts due to affiliate, which are eliminated upon consolidation with the NMM, are included in the accompanying condensed consolidated balance sheets. March 31, 2019 December 31, 2018 Assets Current assets Cash and cash equivalents $ 52,359,206 $ 71,726,342 Investment in marketable securities 1,074,280 1,066,103 Receivables, net 3,096,946 3,904,586 Receivables, net – related party 51,606,081 45,258,916 Prepaid expenses and other current assets 3,944,518 3,647,654 Total current assets 112,081,031 125,603,601 Noncurrent assets Land, property and equipment, net 9,400,074 9,602,228 Intangible assets, net 56,273,585 58,984,420 Goodwill 56,213,450 56,213,450 Loans receivable – related parties 12,500,000 12,500,000 Investment in a privately held entity that does not report net asset value per share 4,725,000 4,725,000 Investments in other entities – equity method 25,881,231 26,707,404 Restricted cash 740,212 745,470 Right-of-use assets 4,216,800 - Other assets 1,282,090 839,085 Total noncurrent assets 171,232,442 170,317,057 Total assets $ 283,313,473 $ 295,920,658 Current liabilities Accounts payable and accrued expenses $ 5,379,342 $ 6,378,751 Fiduciary accounts payable 2,084,926 1,538,598 Medical liabilities 21,610,483 24,983,110 Income taxes payable 12,706,621 11,621,861 Amount due to affiliate 12,197,167 11,505,680 Bank loan - 40,257 Lease liabilities 840,525 - Capital lease obligations 101,741 101,741 Total current liabilities 54,920,805 56,169,998 Noncurrent liabilities Deferred tax liability 13,360,989 15,693,159 Liability for unissued equity shares 1,185,025 1,185,025 Lease liabilities 3,278,928 Capital lease obligations 492,110 517,261 Total noncurrent liabilities 18,317,052 17,395,445 Total liabilities $ 73,237,857 $ 73,565,443 The assets of the Company’s other consolidated VIEs were not considered significant.

Leases

Leases	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
Leases	15. Leases The Company has operating and finance leases for corporate offices, doctors’ offices, and certain equipment. These leases have remaining lease terms of 1 month to 5 years, some of which may include options to extend the leases for up to 10 years, and some of which may include options to terminate the leases within one year. As of March 31, 2019 and December 31, 2018, assets recorded under finance leases were $0.6 million, and accumulated depreciation associated with finance leases was $0.2 million. Also, the Company rents or subleases certain real estate to third parties, which are accounted for as operating leases. Leases with an initial term of 12 months or less are not recorded on the balance sheet. The components of lease expense were as follows: Three Months Ended March 31, 2019 Operating lease cost $ 1,102,684 Finance lease cost Amortization of lease expense $ 25,150 Interest on lease liabilities 4,579 Sublease income $ (100,180 ) Total finance lease cost, net $ 1,032,233 Other information related to leases was as follows: Three Months Ended March 31, 2019 Supplemental Cash Flows Information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 1,033,514 Operating cash flows from finance leases 4,579 Financing cash flows from finance leases 25,150 Right-of-use assets obtained in exchange for lease obligations: Operating leases 8,855,324 Finance leases - Weighted Average Remaining Lease Term Operating leases 4.30 Finance leases 5.25 Weighted Average Discount Rate Operating leases 6.13 % Finance leases 3.00 % Future minimum lease payments under non-cancellable leases as of March 31, 2019 and December 31, 2018 were as follows: March 31, 2019 Operating Leases Finance Leases 2019 (excluding the three months ended March 31, 2019) $ 2,506,838 $ 89,190 2020 2,795,554 118,920 2021 1,595,377 118,920 2022 1,250,897 118,920 2023 971,163 118,920 Thereafter 1,514,842 79,278 Total future minimum lease payments 10,634,671 644,148 Less: imputed interest 2,195,602 50,297 Total lease obligations 8,439,069 593,851 Less: current portion 2,461,924 101,741 Long-term lease obligations $ 5,977,145 $ 492,110 December 31, 2018 Operating Leases Finance Leases 2019 $ 2,848,000 $ 119,000 2020 2,267,000 119,000 2021 783,000 119,000 2022 487,000 119,000 2023 489,000 119,000 Thereafter 243,000 79,000 Total future minimum lease payments 7,117,000 674,000 As of March 31, 2019, the Company does not have additional operating and finance leases that have not yet commenced.

Subsequent Event

Subsequent Event	3 Months Ended
	Mar. 31, 2019
Subsequent Events [Abstract]
Subsequent Event	16. Subsequent Events On April 17, 2019, NMM and APC amended its promissory note with Preferred Bank to increase the amount available under the credit facility from $10 million to $40 million (see Note 8). On April 23, 2019, NMM and APC entered into an agreement whereby NMM and APC NMM’s 25% membership interest in 531 W. College LLC for approximately $8.3 million. Subsequently, APC has a 50% ownership in 531 W. College LLC with a total investment balance of approximately $16.2 million.

Basis of Presentation (Policies

Basis of Presentation (Policies)	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying condensed consolidated balance sheet at December 31, 2018, has been derived from audited consolidated financial statements, but does not include all disclosures required by accounting principles generally accepted in the United States of America (“U.S. GAAP”). The accompanying unaudited condensed consolidated financial statements as of March 31, 2019 and for the three months ended March 31, 2019 and 2018, have been prepared in accordance with U.S. GAAP for interim financial information and with the instructions to Form 10-Q and Article 8 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by U.S. GAAP for complete financial statements, and should be read in conjunction with the audited consolidated financial statements and related notes to the financial statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2018 as filed with the U.S. Securities and Exchange Commission (“SEC”) on March 18, 2019. In the opinion of management, all material adjustments (consisting of normal recurring adjustments) considered necessary for a fair presentation have been made to the condensed consolidated financial statements. The condensed consolidated financial statements include all material adjustments (consisting of normal recurring accruals) necessary to make the condensed consolidated financial statements not misleading as required by Regulation S-X, Rule 10-01. The Company’s quarterly results fluctuate. Operating results for the three months ended March 31, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019 or any future periods.
Principles of Consolidation	Principles of Consolidation The condensed consolidated balance sheets as of March 31, 2019 and December 31, 2018, and the condensed consolidated statements of income for the three months ended March 31, 2019 and 2018, include the accounts of ApolloMed, its consolidated subsidiaries NMM, AMM, APAACO and Apollo Care Connect, including NMM’s subsidiaries, APCN-ACO and AP-ACO, NMM’s consolidated VIE, APC, APC’s subsidiary, UCAP, and APC’s consolidated VIEs, CDSC, APC-LSMA and ICC. All material intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of the condensed consolidated financial statements and related disclosures in conformity with U.S. GAAP 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 consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Significant items subject to such estimates and assumptions include collectability of receivables, recoverability of long-lived and intangible assets, business combination and goodwill valuation and impairment, accrual of medical liabilities (including historical medical loss ratios (“MLR”), and incurred, but not reported (“IBNR”) claims), determination of full-risk and shared-risk revenue and receivables (including constraints and completion factors), income taxes, valuation of share-based compensation and right of use assets and lease liabilities. Management evaluates its estimates and assumptions on an ongoing basis using historical experience and other factors, including the current economic environment, and makes adjustments when facts and circumstances dictate. As future events and their effects cannot be determined with precision, actual results could differ materially from those estimates and assumptions.
Reportable Segments	Reportable Segments The Company operates as one reportable segment, the healthcare delivery segment, and implements and operates innovative health care models to create a patient-centered, physician-centric experience. The Company reports its condensed consolidated financial statements in the aggregate, including all activities in one reportable segment.
Reclassifications	Reclassifications Certain amounts disclosed in prior period financial statements have been reclassified to conform to the current period presentation. These reclassifications had no material effect on the Company’s reported revenue, net income, cash flows or total assets.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company’s cash and cash equivalents primarily consist of money market funds and certificates of deposit. The Company considers all highly liquid investments that are both readily convertible into known amounts of cash and mature within ninety days from their date of purchase to be cash equivalents. The Company maintains its cash in deposit accounts with several banks, which at times may exceed the insured limits of the Federal Deposit Insurance Corporation (“FDIC”). The Company believes it is not exposed to any significant credit risk with respect to its cash, cash equivalents and restricted cash. As of March 31, 2019, the Company’s deposit accounts with banks exceeded the FDIC’s insured limit by approximately $110.0 million. The Company has not experienced any losses to date and performs ongoing evaluations of these financial institutions to limit the Company’s concentration of risk exposure.
Investments in Marketable Securities	Investments in Marketable Securities The appropriate classification of investments is determined at the time of purchase and such designation is reevaluated at each balance sheet date. Investments in marketable debt securities have been classified and accounted for as held-to-maturity based on management’s investment intentions relating to these securities. Held-to-maturity marketable securities are stated at amortized cost, which approximates fair value. As of March 31, 2019 and December 31, 2018, short-term marketable securities in the amount of approximately $1.1 million, consist of certificates of deposit with various financial institutions, reported at par value plus accrued interest, with maturity dates from four months to twelve months (see fair value measurements of financial instruments below). Investments in certificates of deposits are classified as Level 1 investments in the fair value hierarchy.
Receivables and Receivables – Related Parties	Receivables and Receivables – Related Parties The Company’s receivables are comprised of accounts receivable, capitation and claims receivable, risk pool settlements and incentive receivables, management fee income and other receivables. Accounts receivable are recorded and stated at the amount expected to be collected. The Company’s receivables – related parties are comprised of risk pool settlements and incentive receivables, management fee income and other receivables. Receivables – related parties are recorded and stated at the amount expected to be collected. Capitation and claims receivable relate to each health plan’s capitation, which is received by the Company in the month following the month of service. Risk pool settlements and incentive receivables mainly consist of the Company’s full risk pool receivable that is recorded quarterly based on reports received from our hospital partners and management’s estimate of the Company’s portion of the estimated risk pool surplus for open performance years. Settlement of risk pool surplus or deficits occurs approximately 18 months after the risk pool performance year is completed. During the three months ended March 31, 2019, recoverable claims paid related to the 2019 APAACO performance year to be administered following instructions from CMS, fee-for-services (“FFS”) reimbursement for patient care, certain expense reimbursements, transportation reimbursements from the hospitals, and stop loss insurance premium reimbursements are included in “Other receivables” in the accompanying condensed consolidated balance sheet. The Company maintains reserves for potential credit losses on accounts receivable. Management reviews the composition of accounts receivable and analyzes historical bad debts, customer concentrations, customer credit worthiness, current economic trends and changes in customer payment patterns to evaluate the adequacy of these reserves. The Company also regularly analyses the ultimate collectability of accounts receivable after certain stages of the collection cycle using a look-back analysis to determine the amount of receivables subsequently collected and adjustments are recorded when necessary. Reserves are recorded primarily on a specific identification basis. Amounts are recorded as a receivable when the Company is able to determine amounts receivable under these contracts and/or agreements based on information provided and collection is reasonably likely to occur. The Company continuously monitors its collections of receivables and its policy is to write off receivables when they are determined to be uncollectible. As of March 31, 2019 and December 31, 2018, the Company’s allowance for doubtful accounts was approximately $5.2 million and approximately $4.3 million, respectively.
Concentrations of Risks	Concentrations of Risks The Company disaggregates revenue from contracts by service type and by payor. This level of detail provides useful information pertaining to how the Company generates revenue by significant revenue stream and by type of direct contracts. The consolidated statements of income present disaggregated revenue by service type. The following table presents disaggregated revenue generated by each payor type for the three months ended March 31, 2019 and 2018 : Three Months Ended March 31, 2019 2018 Commercial $ 31,784,992 $ 105,106,621 Medicare 22,947,690 18,541,115 Medicaid 32,820,500 176,350 Other third parties 8,203,989 99,160 Revenue $ 95,757,171 $ 123,923,246 The Company had major payors that contributed the following percentage of net revenue: For the Three Months Ended March 31, 2019 2018 Payor A 17.4 % * % Payor B 15.3 % 12.0 % Payor C 12.0 % 10.9 % * Less than 10% of total net revenues The Company had major payors that contributed to the following percentage of receivables and receivables – related parties before the allowance for doubtful accounts: As of March 31, 2019 As of December 31, 2018 Payor D 35.3 % 34.1 % Payor E 42.9 % 42.2 %
Fair Value Measurements of Financial Instruments	Fair Value Measurements of Financial Instruments The Company’s financial instruments consist of cash and cash equivalents, fiduciary cash, restricted cash, investment in marketable securities, receivables, loans receivable, accounts payable, certain accrued expenses, capital lease obligations, bank loan and the line of credit. The carrying values of the financial instruments classified as current in the accompanying condensed consolidated balance sheets are considered to be at their fair values, due to the short maturity of these instruments. The carrying amounts of the loan receivables – long term, bank loan, capital lease obligations and line of credit approximate fair value as they bear interest at rates that approximate current market rates for debt with similar maturities and credit quality. Financial Accounting Standards Board (“FASB”) ASC 820, Fair Value Measurement (“ASC 820”), applies to all financial assets and financial liabilities that are measured and reported on a fair value basis and requires disclosure that establishes a framework for measuring fair value and expands disclosure about fair value measurements. ASC 820 establishes a fair value hierarchy for disclosures of the inputs to valuations used to measure fair value. This hierarchy prioritizes the inputs into three broad levels as follows: Level 1 —Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that can be accessed at the measurement date. Level 2 —Inputs include quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets or liabilities in markets that are not active, inputs other than quoted prices that are observable for the asset or liability (i.e., interest rates and yield curves), and inputs that are derived principally from or corroborated by observable market data by correlation or other means (market corroborated inputs). Level 3 —Unobservable inputs that reflect assumptions about what market participants would use in pricing the asset or liability. These inputs would be based on the best information available, including the Company’s own data. The carrying amounts and fair values of the Company’s financial instruments as of March 31, 2019 are presented below: Fair Value Measurements Level 1 Level 2 Level 3 Total Assets Money market funds* $ 68,004,532 $ - $ - $ 68,004,532 Marketable securities – certificates of deposit 1,074,280 - - 1,074,280 Marketable securities – equity securities 68,726 - - 68,726 Total $ 69,147,538 $ - $ - $ 69,147,538 The carrying amounts and fair values of the Company’s financial instruments as of December 31, 2018 are presented below: Fair Value Measurements Level 1 Level 2 Level 3 Total Assets Money market funds* $ 85,500,745 $ - $ - $ 85,500,745 Marketable securities – certificates of deposit 1,066,103 - - 1,066,103 Marketable securities – equity securities 60,999 - - 60,999 Total $ 86,627,847 $ - $ - $ 86,627,847 * Included in cash and cash equivalents There were no Level 3 inputs measured on a recurring basis for the three months ended March 31, 2019. There have been no changes in Level 1, Level 2, or Level 3 classification and no changes in valuation techniques for these assets for the three months ended March 31, 2019 and December 31, 2018.
Intangible Assets and Long-Lived Assets	Intangible Assets and Long-Lived Assets Intangible assets with finite lives include network-payor relationships, management contracts and member relationships and are stated at cost, less accumulated amortization and impairment losses. These intangible assets are amortized on the accelerated method using the discounted cash flow rate. Intangible assets with finite lives also include a patient management platform, as well as trade names and trademarks, whose valuations were determined using the cost to recreate method and the relief from royalty method, respectively. These assets are stated at cost, less accumulated amortization and impairment losses, and are amortized using the straight-line method. Finite-lived intangibles and long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. If the expected future cash flows from the use of such assets (undiscounted and without interest charges) are less than the carrying value, a write-down would be recorded to reduce the carrying value of the asset to its estimated fair value. Fair value is determined based on appropriate valuation techniques. The Company determined that there was no impairment of its finite-lived intangible or long-lived assets during the three months ended March 31, 2019 and 2018.
Goodwill and Indefinite-Lived Intangible Assets	Goodwill and Indefinite-Lived Intangible Assets Under the ASC 350, Intangibles – Goodwill and Other (“ASC 350”), goodwill and indefinite-lived intangible assets are reviewed at least annually for impairment. At least annually, at the Company’s fiscal year end, or sooner if events or changes in circumstances indicate that an impairment has occurred, the Company performs a qualitative assessment to determine whether it is more likely than not that the fair value of each reporting unit is less than its carrying amount as a basis for determining whether it is necessary to complete quantitative impairment assessments for each of the Company’s three main reporting units (1) management services, (2) IPA, and (3) ACO. The Company is required to perform a quantitative goodwill impairment test only if the conclusion from the qualitative assessment is that it is more likely than not that a reporting unit’s fair value is less than the carrying value of its assets. Should this be the case, a quantitative analysis is performed to identify whether a potential impairment exists by comparing the estimated fair values of the reporting units with their respective carrying values, including goodwill. An impairment loss is recognized if the implied fair value of the asset being tested is less than its carrying value. In this event, the asset is written down accordingly. The fair values of goodwill are determined using valuation techniques based on estimates, judgments and assumptions management believes are appropriate in the circumstances. At least annually, indefinite-lived intangible assets are tested for impairment. Impairment for intangible assets with indefinite lives exists if the carrying value of the intangible asset exceeds its fair value. The fair values of indefinite-lived intangible assets are determined using valuation techniques based on estimates, judgments and assumptions management believes are appropriate in the circumstances. The Company determined that there was no impairment of its goodwill or indefinite-lived intangible assets during the three months ended March 31, 2019 and 2018.
Investments in Other Entities - Equity Method	Investments in Other Entities - Equity Method The Company accounts for certain investments using the equity method of accounting when it is determined that the investment provides the Company with the ability to exercise significant influence, but not control, over the investee. Significant influence is generally deemed to exist if the Company has an ownership interest in the voting stock of the investee of between 20% and 50%, although other factors, such as representation on the investee’s board of directors, are considered in determining whether the equity method of accounting is appropriate.
Medical Liabilities	Medical Liabilities APC, APAACO and MMG are responsible for integrated care that the associated physicians and contracted hospitals provide to its enrollees. APC, APAACO and MMG provide integrated care to HMOs, Medicare and Medi-Cal enrollees through a network of contracted providers under sub-capitation and direct patient service arrangements. Medical costs for professional and institutional services rendered by contracted providers are recorded as cost of services expenses in the accompanying condensed consolidated statements of income. An estimate of amounts due to contracted physicians, hospitals, and other professional providers is included in medical liabilities in the accompanying condensed consolidated balance sheets. Medical liabilities include claims reported as of the balance sheet date and estimates IBNR claims. Such estimates are developed using actuarial methods and are based on numerous variables, including the utilization of health care services, historical payment patterns, cost trends, product mix, seasonality, changes in membership, and other factors. The estimation methods and the resulting reserves are periodically reviewed and updated. Many of the medical contracts are complex in nature and may be subject to differing interpretations regarding amounts due for the provision of various services. Such differing interpretations may not come to light until a substantial period of time has passed following the contract implementation.
Revenue Recognition	Revenue Recognition The Company adopted Accounting Standards Update (“ASU”) 2014-09, “Revenue from Contracts with Customers (Topic 606)” on January 1, 2018 and recognizes revenue in accordance with the applicable guidance. The Company receives payments from the following sources for services rendered: (i) commercial insurers; (ii) the federal government under the Medicare program administered by CMS; (iii) state governments under the Medicaid and other programs; (iv) other third party payors (e.g., hospitals and IPAs); and (v) individual patients and clients. Nature of Services and Revenue Streams Revenue primarily consists of capitation revenue, risk pool settlements and incentives, NGACO All-Inclusive Population-Based Payments (“AIPBP”) revenue, management fee income, and FFS revenue. Revenue is recorded in the period in which services are rendered or the period in which the Company is obligated to provide services. The form of billing and related risk of collection for such services may vary by type of revenue and the customer. The following is a summary of the principal forms of the Company’s billing arrangements and how revenue is recognized for each. Capitation, net Managed care revenues of the Company consist primarily of capitated fees for medical services provided by the Company under a capitated arrangement directly made with various managed care providers including HMOs. Capitation revenue is typically prepaid monthly to the Company based on the number of enrollees selecting the Company as their healthcare provider. Capitation revenue is recognized in the month in which the Company is obligated to provide services to plan enrollees under contracts with various health plans. Minor ongoing adjustments to prior months’ capitation, primarily arising from contracted HMOs finalizing their monthly patient eligibility data for additions or subtractions of enrollees, are recognized in the month they are communicated to the Company. Additionally, Medicare pays capitation using a “Risk Adjustment” model, which compensates managed care organizations and providers based on the health status (acuity) of each individual enrollee. Health plans and providers with higher acuity enrollees will receive more and those with lower acuity enrollees will receive less. Under Risk Adjustment, capitation is determined based on health severity, measured using patient encounter data. Capitation is paid on a monthly basis based on data submitted for the enrollee for the preceding year and is adjusted in subsequent periods after the final data is compiled. Positive or negative capitation adjustments are made for Medicare enrollees with conditions requiring more or less healthcare services than assumed in the interim payments. Since the Company cannot reliably predict these adjustments, periodic changes in capitation amounts earned as a result of Risk Adjustment are recognized when those changes are communicated by the health plans to the Company. PMPM managed care contracts generally have a term of one year or longer. All managed care contracts have a single performance obligation that constitutes a series for the provision of managed healthcare services for a population of enrolled members for the duration of the contract. The transaction price for PMPM contracts is variable as it primarily includes PMPM fees associated with unspecified membership that fluctuates throughout the contract. In certain contracts, PMPM fees also include adjustments for items such as performance incentives, performance guarantees and risk shares. The Company generally estimates the transaction price using the most likely methodology and amounts are only included in the net transaction price to the extent that it is probable that a significant reversal of cumulative revenue will not occur once any uncertainty is resolved. The majority of the Company’s net PMPM transaction price relates specifically to the Company’s efforts to transfer the service for a distinct increment of the series (e.g. day or month) and is recognized as revenue in the month in which members are entitled to service. Risk Pool Settlements and Incentives APC enters into full risk capitation arrangements with certain health plans and local hospitals, which are administered by a third party, where the hospital is responsible for providing, arranging and paying for institutional risk and APC is responsible for providing, arranging and paying for professional risk. Under a full risk pool sharing agreement, APC generally receives a percentage of the net surplus from the affiliated hospital’s risk pools with HMOs after deductions for the affiliated hospital’s costs. Advance settlement payments are typically made quarterly in arrears if there is a surplus. Risk pool settlements under arrangements with health plans and hospitals are recognized using the most likely methodology and amounts are only included in revenue to the extent that it is probable that a significant reversal of cumulative revenue will not occur once any uncertainty is resolved. The assumptions for historical MLR, IBNR completion factor and constraint percentages were used by management in applying the most likely method. Under capitated arrangements with certain HMOs APC participates in one or more shared risk arrangements relating to the provision of institutional services to enrollees (shared risk arrangements) and thus can earn additional revenue or incur losses based upon the enrollee utilization of institutional services. Shared risk capitation arrangements are entered into with certain health plans, which are administered by the health plan, where APC is responsible for rendering professional services, but the health plan does not enter into a capitation arrangement with a hospital and therefore the health plan retains the institutional risk. Shared risk deficits, if any, are not payable until and unless (and only to the extent of any) risk sharing surpluses are generated. At the termination of the HMO contract, any accumulated deficit will be extinguished. Risk pool settlements under arrangements with HMOs are recognized, using the most likely methodology, and only included in revenue to the extent that it is probable that a significant reversal of cumulative revenue will not occur. Given the lack of access to the health plans’ data and control over the members assigned to APC, the adjustments and/or the withheld amounts are unpredictable and as such APC’s risk share revenue is deemed to be fully constrained until APC is notified of the amount by the health plan. Risk pools for the prior contract years are generally final settled in the third or fourth quarter of the following year. In addition to risk-sharing revenues, the Company also receives incentives under “pay-for-performance” programs for quality medical care, based on various criteria. As an incentive to control enrollee utilization and to promote quality care, certain HMOs have designed the quality incentive programs and commercial generic pharmacy incentive programs to compensate the Company for efforts it takes to improve the quality of services and for efficient and effective use of pharmacy supplemental benefits provided to the HMO’s members. The incentive programs track specific performance measures and calculate payments to the Company based on the performance measures. Incentives earned under “pay-for-performance” programs are recognized using the most likely methodology. However, as the Company does not have sufficient insight from the health plans on the amount and timing of the shared risk pool and incentive payments, these amounts are considered to be fully constrained and only recorded when such payments are known and/or received. Generally, for the foregoing arrangements, the final settlement is dependent on each distinct day’s performance within the annual measurement period but cannot be allocated to specific days until the full measurement period has occurred and performance can be assessed. As such, this is a form of variable consideration estimated at contract inception and updated through the measurement period (i.e. the contract year), to the extent the risk of reversal does not exist and the consideration is not constrained. NGACO AIPBP Revenue APAACO and CMS entered into a Next Generation ACO Model Participation Agreement (the “Participation Agreement”) with an initial term of two performance years through December 31, 2018, which has been extended for another two renewal years. For each performance year, the Company shall submit to CMS its selections for risk arrangement; the amount of the profit/loss cap; alternative payment mechanism; benefits enhancements, if any; and its decision regarding voluntary alignment under the NGACO Model. The Company must obtain CMS consent before voluntarily discontinuing any benefit enhancement during a performance year. Under the NGACO Model, CMS aligns beneficiaries to the Company to manage (direct care and pay providers) based on a budgetary benchmark established with CMS. The Company is responsible for managing medical costs for these beneficiaries. The beneficiaries will receive services from physicians and other medical service providers that are both in-network and out-of-network. The Company receives capitation from CMS on a monthly basis to pay claims from in-network providers. The Company records such capitation received from CMS as revenue as the Company is primarily responsible and liable for managing the patient care and for satisfying provider obligations, is assuming the credit risk for the services provided by in-network providers through its arrangement with CMS, and has control of the funds, the services provided and the process by which the providers are ultimately paid. Claims from out-of-network providers are processed and paid by CMS and the Company’s shared savings or losses in managing the services provided by out-of-network providers are generally determined on an annual basis after reconciliation with CMS. Pursuant to the Company’s risk share agreement with CMS, the Company will be eligible to receive the savings or be liable for the deficit according to the budget established by CMS based on the Company’s efficiency or lack thereof, respectively, in managing how the beneficiaries aligned to the Company by CMS are served by in-network and out-of-network providers. The Company’s savings or losses on providing such services are both capped by CMS, and are subject to significant estimation risk, whereby payments can vary significantly depending upon certain patient characteristics and other variable factors. Accordingly, the Company recognizes such surplus or deficit upon substantial completion of reconciliation and determination of the amounts. The Company records NGACO capitation revenues monthly, as that is when the Company is obligated to provide services to its members. Excess, over claims paid plus an estimate for the related IBNR (see Note 7), monthly capitation received are deferred and recorded as a liability until actual claims are paid or incurred. CMS will determine if there were any excess capitation paid for the performance year and the excess is refunded to CMS. Further, in accordance with the guidance in ASC 606-10-55-36 through 55-40 on principal versus agent considerations, the Company records such revenues in the gross amount of consideration. For each performance year, CMS shall pay the Company in accordance with the alternative payment mechanism, if any, for which CMS has approved the Company; the risk arrangement for which the Company has been approved by CMS; and as otherwise provided in the Participation Agreement. Following the end of each performance year and at such other times as may be required under the Participation Agreement, CMS will issue a settlement report to the Company setting forth the amount of any shared savings or shared losses and the amount of other monies. If CMS owes the Company shared savings or other monies, CMS shall pay the Company in full within 30 days after the date on which the relevant settlement report is deemed final, except as provided in the Participation Agreement. If the Company owes CMS shared losses or other monies owed as a result of a final settlement, the Company shall pay CMS in full within 30 days after the relevant settlement report is deemed final. If the Company fails to pay the amounts due to CMS in full within 30 days after the date of a demand letter or settlement report, CMS shall assess simple interest on the unpaid balance at the rate applicable to other Medicare debts under current provisions of law and applicable regulations. In addition, CMS and the U.S. Department of the Treasury may use any applicable debt collection tools available to collect any amounts owed by the Company. The Company participates in the AIPBP track of the NGACO Model. Under the AIPBP track, CMS estimates the total annual expenditures for APAACO’s assigned patients and pays that projected amount to the Company in monthly installments, and the Company is responsible for all Part A and Part B costs for in-network participating providers and preferred providers contracted by the Company to provide services to the assigned patients. As APAACO does not have sufficient insight into the financial performance of the shared risk pool with CMS because of unknown factors related to IBNR, risk adjustment factors, stop loss provisions, among other factors, an estimate cannot be developed. Due to these limitations, APAACO cannot determine the amount of surplus or deficit that will probably not be reversed in the future and therefore this shared risk pool revenue is considered fully constrained. For performance year 2018, the Company received monthly AIPBP payments at a rate of approximately $7.3 million per month from CMS that started in February 2018, which was reduced to $5.5 million per month beginning October 1, 2018. The Company will need to continue to comply with all terms and conditions in the Participation Agreement and various regulatory requirements to be eligible to participate in the AIPBP mechanism and/or NGACO Model. The Company continues to be eligible in receiving AIPBP payments under the NGACO Model for performance year 2019, with the effective date of the performance year beginning April 1, 2019. The monthly AIPBP payments have been increased from approximately $5.5 million to approximately $8.3 million per month for performance year 2019. The Company has received approximately $24.8 million in total AIPBP payments for the three months ended March 31, 2019 and have recorded the entire amount received as deferred revenue included in “Accounts payable and accrued expenses” in the accompanying condensed consolidated balance sheet. The Company also recorded an asset of approximately $11.2 million related to recoverable claims paid during the three months ended March 31, 2019 which will be administered following instructions from CMS. This balance is included in “Other receivables” in the accompanying condensed consolidated balance sheet. Management Fee Income Management fee income encompasses fees paid for management, physician advisory, healthcare staffing, administrative and other non-medical services provided by the Company to IPAs, hospitals and other healthcare providers. Such fees may be in the form of billings at agreed-upon hourly rates, percentages of revenue or fee collections, or amounts fixed on a monthly, quarterly or annual basis. The revenue may include variable arrangements measuring factors such as hours staffed, patient visits or collections per visit against benchmarks, and, in certain cases, may be subject to achieving quality metrics or fee collections. The Company recognizes such variable supplemental revenues in the period when such amounts are determined to be fixed and therefore contractually obligated as payable by the customer under the terms of the respective agreement. The Company’s MSA revenue also includes revenue sharing payments from the Company’s partners based on their non-medical services. The Company provides a significant service of integrating the services selected by the Company’s clients into one overall output for which the client has contracted. Therefore, such management contracts generally contain a single performance obligation. The nature of the Company’s performance obligation is to stand ready to provide services over the contractual period. Also, the Company’s performance obligation forms a series of distinct periods of time over which the Company stands ready to perform. The Company’s performance obligation is satisfied as the Company completes each period’s obligations. Consideration from management contracts is variable in nature because the majority of the fees are generally based on revenue or collections, which can vary from period to period. The Company has control over pricing. Contractual fees are invoiced to the Company’s clients generally monthly and payment terms are typically due within 30 days. The variable consideration in the Company’s management contracts meets the criteria to be allocated to the distinct period of time to which it relates because (i) it is due to the activities performed to satisfy the performance obligation during that period and (ii) it represents the consideration to which the Company expects to be entitled. The Company’s management contracts generally have long terms (e.g., ten years), although they may be terminated earlier under the terms of the respective contracts. Since the remaining variable consideration will be allocated to a wholly unsatisfied promise that forms part of a single performance obligation recognized under the series guidance, the Company has applied the optional exemption to exclude disclosure of the allocation of the transaction price to remaining performance obligations. Fee-for-Service Revenue FFS revenue represents revenue earned under contracts in which the Company bills and collects the professional component of charges for medical services rendered by the Company’s contracted physicians and employed physicians. Under the FFS arrangements, the Company bills the hospitals and third-party payors for the physician staffing and further bills patients or their third-party payors for patient care services provided and receives payment. FFS revenue related to the patient care services is reported net of contractual allowances and policy discounts and are recognized in the period in which the services are rendered to specific patients. All services provided are expected to result in cash flows and are therefore reflected as net revenue in the financial statements. The recognition of net revenue (gross charges less contractual allowances) from such services is dependent on such factors as proper completion of medical charts following a patient visit, the forwarding of such charts to the Company’s billing center for medical coding and entering into the Company’s billing system and the verification of each patient’s submission or representation at the time services are rendered as to the payor(s) responsible for payment of such services. Revenue is recorded based on the information known at the time of entering of such information into the Company’s billing systems as well as an estimate of the revenue associated with medical services. The Company is responsible for confirming member eligibility, performing program utilization review, potentially directing payment to the provider and accepting the financial risk of loss associated with services rendered, as specified within the Company’s client contracts. The Company has the ability to adjust contractual fees with clients and possess the financial risk of loss in certain contractual obligations. These factors indicate the Company is the principal and, as such, the Company records gross fees contracted with clients in revenues. Consideration from FFS arrangements is variable in nature because fees are based on patient encounters, credits due to clients and reimbursement of provider costs, all of which can vary from period to period. Patient encounters and related episodes of care and procedures qualify as distinct goods and services, provided simultaneously together with other readily available resources, in a single instance of service, and thereby constitute a single performance obligation for each patient encounter and, in most instances, occur at readily determinable transaction prices. As a practical expedient, the Company adopted a portfolio approach for the FFS revenue stream to group contracts with similar characteristics and analyze historical cash collections trends. The contracts within the portfolio share the characteristics conducive to ensuring that the results do not materially differ under the new standard if it were to be applied to individual patient contracts related to each patient encounter. Accordingly, there was not a change in the Company's method to recognize revenue under ASC 606 from the previous accounting guidance. Estimating net FFS revenue is a complex process, largely due to the volume of transactions, the number and complexity of contracts with payors, the limited availability at times of certain patient and payor information at the time services are provided, and the length of time it takes for collections to fully mature. These expected collections are based on fees and negotiated payment rates in the case of third-party payors, the specific benefits provided for under each patient's healthcare plans, mandated payment rates in the case of Medicare and Medicaid programs, and historical cash collections (net of recoveries) in combination with expected collections from third party payors. The relationship between gross charges and the transaction price recognized is significantly influenced by payor mix, as collections on gross charges may vary significantly, depending on whether and with whom the patients the Company provides services to in the period are insured and the Company's contractual relationships with those payors. Payor mix is subject to change as additional patient and payor information is obtained after the period services are provided. The Company periodically assesses the estimates of unbilled revenue, contractual adjustments and discounts, and payor mix by analyzing actual results, including cash collections, against estimates. Changes in these estimates are charged or credited to the consolidated statement of income in the period that the assessment is made. Significant changes in payor mix, contractual arrangements with payors, specialty mix, acuity, general economic conditions and health care coverage provided by federal or state governments or private insurers may have a significant impact on estimates and significantly affect the results of operations and cash flows. Contract Assets Typically, revenues and receivables are recognized once the Company has satisfied its performance obligation. Accordingly, the Company’s contract assets are comprised of receivables and receivables – related parties. Generally, the Company does not have material amounts of other contract assets. The Company's billing and accounting systems provide historical trends of cash collections and contractual write-offs, accounts receivable agings and established fee adjustments from third-party payors. These estimates are recorded and monitored monthly as revenues are recognized. The principal exposure for uncollectible fee for service visits is from self-pay patients and, to a lesser extent, for co-payments and deductibles from patients with insurance. Contract Liabilities (Deferred Revenue ) Contract liabilities are recorded when cash payments are received in advance of the Company’s performance, or in the case of the Company’s NGACO, the excess of AIPBP capitation received and the actual claims paid or incurred. The Company’s contract liability balance was $33.2 million and $9.1 million as of March 31, 2019 and December 31, 2018, respectively, and is presented within “Accounts payable and the accompanying condensed consolidated balance sheets. During the three months ended March 31, 2019, $0.1 million of the Company’s contracted liability accrued in 2018 has been recognized as revenue.
Leases	Leases On January 1, 2019, the Company adopted Accounting Standards Update (“ASU”) 2016-02, “Leases (Topic 842).” Refer to “Recent Accounting Pronouncements” below and to Note 15 – Leases for further details. The Company determines if an arrangement is a lease at inception. Operating leases are included in “Right-of-use assets”, and “Lease liabilities” in the accompanying condensed consolidated balance sheets. Finance leases are included in “Land, property and equipment, net” and “Capital lease obligations” in the accompanying condensed consolidated balance sheets. Operating lease ROU assets and operating lease liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. As none of our leases provide an implicit rate, we use our incremental borrowing rate based on the information available at commencement date in determining the present value of future payments. Our lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term.
Income Taxes	Income Taxes Federal and state income taxes are computed at currently enacted tax rates less tax credits using the asset and liability method. Deferred taxes are adjusted both for items that do not have tax consequences and for the cumulative effect of any changes in tax rates from those previously used to determine deferred tax assets or liabilities. Tax provisions include amounts that are currently payable, changes in deferred tax assets and liabilities that arise because of temporary differences between the timing of when items of income and expense are recognized for financial reporting and income tax purposes, changes in the recognition of tax positions and any changes in the valuation allowance caused by a change in judgment about the realizability of the related deferred tax assets. A valuation allowance is established when necessary to reduce deferred tax assets to amounts expected to be realized. The Company uses a recognition threshold of more-likely-than-not and a measurement attribute on all tax positions taken or expected to be taken in a tax return in order to be recognized in the financial statements. Once the recognition threshold is met, the tax position is then measured to determine the actual amount of benefit to recognize in the financial statements.
Share-based Compensation	Share-Based Compensation The Company maintains a stock-based compensation program for employees, non-employees, directors and consultants. The value of share-based awards such as options is recognized as compensation expense on a cumulative straight-line basis over the vesting terms of the awards, adjusted for expected forfeitures. At times, the Company issues shares of its common stock to its employees, directors and consultants, which shares may be subject to the Company’s repurchase right (but not obligation) that lapses based on performance of services in the future. The Company accounts for share-based awards granted to persons other than employees and directors under ASC 505-50 Equity-Based Payments to Non-Employees . As such the fair value of such shares of stock is periodically re-measured using an appropriate valuation model and income or expense is recognized over the vesting period.
Basic and Diluted Earnings Per Share	Basic and Diluted Earnings Per Share Basic earnings per share (“EPS”) is computed by dividing net income attributable to holders of the Company’s common stock by the weighted average number of shares of common stock outstanding during the periods presented. Diluted earnings per share is computed using the weighted average number of shares of common stock outstanding plus the effect of dilutive securities outstanding during the periods presented, using the treasury stock method. Refer to Note 13 for a discussion of shares treated as treasury shares for accounting purposes.
Non-controlling Interests	Noncontrolling Interests The Company consolidates entities in which the Company has a controlling financial interest. The Company consolidates subsidiaries in which the Company holds, directly or indirectly, more than 50% of the voting rights, and VIEs in which the Company is the primary beneficiary. Noncontrolling interests represent third-party equity ownership interests (including certain VIEs) in the Company’s consolidated entities. The amount of net income attributable to noncontrolling interests is disclosed in the consolidated statements of income.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In February 2016, the FASB issued ASU No. 2016-02, “Leases (Topic 842)” (“ASC 842”), which amends the existing accounting standards for leases to increase transparency and comparability among organizations by requiring the recognition of right of use (“ROU”) assets and lease liabilities on the balance sheet. Most prominent among the changes in the standard is the recognition of ROU assets and lease liabilities by lessees for those leases classified as operating leases. Under the standard, disclosures are required to meet the objective of enabling users of financial statements to assess the amount, timing, and uncertainty of cash flows arising from leases. The Company adopted ASC 842 effective January 1, 2019 using the following practical expedients as permitted under the transition guidance within the new standard; (i) not reassess whether any expired or existing contracts are or contain leases; not reassess the lease classification for any expired or existing leases; not reassess initial direct costs for existing leases; and (ii) use hindsight in determining the lease term and in assessing impairment of the entity’s ROU assets. The Company has also implemented additional internal controls to enable future preparation of financial information in accordance with ASC 842. The standard had a material impact on our consolidated balance sheets, but did not materially impact our consolidated results of operations and had no impact on cash flows. The most significant impact was the recognition of ROU assets of $9.0 million and lease liabilities of $8.9 million for operating leases, while our accounting for finance leases remained substantially unchanged. The 2018 comparative information has not been restated and continues to be reported under the accounting standards in effect for that period (ASC 840). Refer to Note 15 – Leases for further details. ASC 842 provides a number of optional practical expedients in transition. The Company elected: (1) the “package of practical expedients”, which permits it not to reassess under the new standard its prior conclusions about lease identification, lease classification, and initial direct costs, and (2) the use-of-hindsight in determining the lease term and in assessing impairment of ROU assets. In addition, ASC 842 provides practical expedients for an entity’s ongoing accounting that the Company has elected, comprised of the following: (1) the election for classes of underlying asset to not separate non-lease components from lease components, and (2) the election for short-term lease recognition exemption for all leases that qualify. Refer to Note 15 – Leases for further details. In June 2016, the FASB issued ASU No. 2016-13, “Financial Instruments-Credit Losses (Topic 326)-Measurement of Credit Losses on Financial Instruments” (“ASU 2016-13”). The new standard requires entities to measure all expected credit losses for financial assets held at the reporting date based on historical experience, current conditions and reasonable and supportable forecasts. ASU 2016-13 will become effective for fiscal years beginning after December 15, 2019, with early adoption permitted. The Company is currently evaluating the impact ASU 2016-13 will have on the condensed consolidated financial statements. In July 2017, the FASB issued ASU No. 2017-11, “Earnings Per Share (Topic 260): Distinguishing Liabilities from Equity (Topic 480); Derivatives and Hedging (Topic 815): (Part 1) Accounting for Certain Financial Instruments with Down Round Features, (Part II) Replacement of the Indefinite Deferral for Mandatorily Redeemable Financial Instruments of Certain Nonpublic Entities and Certain Mandatorily Redeemable Non-controlling Interests with a Scope Exception” (“ASU 2017-11”). The amendments in Part I of this Update change the classification analysis of certain equity-linked financial instruments (or embedded features) with down round features. When determining whether certain financial instruments should be classified as liabilities or equity instruments, a down round feature no longer precludes equity classification when assessing whether the instrument is indexed to an entity’s own stock. The amendments also clarify existing disclosure requirements for equity-classified instruments. The amendments in Part 1 of this update are effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2018. Early adoption is permitted, including adoption in any interim period. If an entity early adopts the amendments in an interim period, any adjustments should be reflected as of the beginning of the fiscal year that includes that interim period. The Company adopted ASU 2017-11 on January 1, 2019. The adoption of ASU 2017-11 did not have a material impact on the Company’s condensed consolidated financial statements. In October 2018, the FASB issued ASU No. 2018-17, “Consolidation (Topic 810): Targeted Improvements to Related Party Guidance for Variable Interest Entities” (“ASU 2018-17”). This ASU reduces the cost and complexity of financial reporting associated with consolidation of variable interest entities (VIEs). A VIE is an organization in which consolidation is not based on a majority of voting rights. The new guidance supersedes the private company alternative for common control leasing arrangements issued in 2014 and expands it to all qualifying common control arrangements. The amendments in this ASU are effective for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years. The Company is currently assessing the impact the adoption of ASU 2018-17 will have on the Company’s condensed consolidated financial statements. With the exception of the new standards discussed above, there have been no other new accounting pronouncements that have significance, or potential significance, to the Company’s financial position, results of operations and cash flows.

Basis of Presentation (Tables)

Basis of Presentation (Tables)	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
Schedule of Disaggregated Revenue By Each Payor	The following table presents disaggregated revenue generated by each payor type for the three months ended March 31, 2019 and 2018 : Three Months Ended March 31, 2019 2018 Commercial $ 31,784,992 $ 105,106,621 Medicare 22,947,690 18,541,115 Medicaid 32,820,500 176,350 Other third parties 8,203,989 99,160 Revenue $ 95,757,171 $ 123,923,246
Schedule of Revenue by Major Customers by Reporting Segments	The Company had major payors that contributed the following percentage of net revenue: For the Three Months Ended March 31, 2019 2018 Payor A 17.4 % * % Payor B 15.3 % 12.0 % Payor C 12.0 % 10.9 % * Less than 10% of total net revenues The Company had major payors that contributed to the following percentage of receivables and receivables – related parties before the allowance for doubtful accounts: As of March 31, 2019 As of December 31, 2018 Payor D 35.3 % 34.1 % Payor E 42.9 % 42.2 %
Fair Value Measurements, Recurring and Nonrecurring	The carrying amounts and fair values of the Company’s financial instruments as of March 31, 2019 are presented below: Fair Value Measurements Level 1 Level 2 Level 3 Total Assets Money market funds* $ 68,004,532 $ - $ - $ 68,004,532 Marketable securities – certificates of deposit 1,074,280 - - 1,074,280 Marketable securities – equity securities 68,726 - - 68,726 Total $ 69,147,538 $ - $ - $ 69,147,538 The carrying amounts and fair values of the Company’s financial instruments as of December 31, 2018 are presented below: Fair Value Measurements Level 1 Level 2 Level 3 Total Assets Money market funds* $ 85,500,745 $ - $ - $ 85,500,745 Marketable securities – certificates of deposit 1,066,103 - - 1,066,103 Marketable securities – equity securities 60,999 - - 60,999 Total $ 86,627,847 $ - $ - $ 86,627,847 * Included in cash and cash equivalents

Intangible Assets, Net (Tables)

Intangible Assets, Net (Tables)	3 Months Ended
	Mar. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of intangible assets	At March 31, 2019, the Company’s intangible assets, net, consisted of the following: Useful Gross Net Life March 31, Accumulated March 31, (Years) 2019 Amortization 2019 Indefinite Lived Assets: Medicare license N/A $ 1,994,000 $ - $ 1,994,000 Amortized Intangible Assets: Network relationships 11 15 109,883,000 (51,215,352 ) 58,667,648 Management contracts 15 22,832,000 (8,031,971 ) 14,800,029 Member relationships 12 6,696,000 (1,555,286 ) 5,140,714 Patient management platform 5 2,060,000 (549,333 ) 1,510,667 Tradename/trademarks 20 1,011,000 (67,400 ) 943,600 $ 144,476,000 $ (61,419,342 ) $ 83,056,658 At December 31, 2018, the Company’s intangible assets, net, consisted of the following: Useful Gross Net Life December 31, Accumulated December 31, (Years) 2018 Amortization 2018 Indefinite Lived Assets: Medicare license N/A $ 1,994,000 $ - $ 1,994,000 Amortized Intangible Assets: Network relationships 11 15 109,883,000 (48,361,773 ) 61,521,227 Management contracts 15 22,832,000 (7,447,581 ) 15,384,419 Member relationships 12 6,696,000 (1,289,667 ) 5,406,333 Patient management platform 5 2,060,000 (446,333 ) 1,613,667 Tradename/trademarks 20 1,011,000 (54,763 ) 956,237 $ 144,476,000 $ (57,600,117 ) $ 86,875,883
Schedule of future amortization expense	Future amortization expense is estimated to be as follows for the years ending December 31: Amount 2019 (excluding the three months ended March 31, 2019) $ 10,661,000 2020 12,671,000 2021 10,960,000 2022 9,448,000 2023 7,790,000 Thereafter 29,532,000 $ 81,062,000

Investments in Other Entities (

Investments in Other Entities (Tables)	3 Months Ended
	Mar. 31, 2019
Equity Method Investments	Investments in other entities – equity method consisted of the following: March 31, 2019 December 31, 2018 Universal Care, Inc. $ 3,673,132 $ 2,635,945 LaSalle Medical Associates – IPA Line of Business 5,980,923 7,054,888 Diagnostic Medical Group 2,481,166 2,257,346 Pacific Medical Imaging & Oncology Center, Inc. 1,429,960 1,359,494 Pacific Ambulatory Surgery Center, LLC - 285,198 Accountable Health Care IPA- related party 4,202,958 4,977,957 531 W. College, LLC – related party 16,226,184 16,273,152 MWN, LLC – related party 33,000 33,000 $ 34,027,323 $ 34,876,980
LaSalle Medical Associates IPA [Member]
Equity Method Investments	LMA’s summarized balance sheets at March 31, 2019 and December 31, 2018 and summarized statements of operations for the three months ended March 31, 2019 and 2018 with respect to its IPA line of business are as follows: Balance Sheets March 31, 2019 December 31, 2018 Assets Cash and cash equivalents $ 204,981 $ 18,444,702 Receivables, net 7,116,487 2,897,337 Other current assets 3,526,319 5,459,442 Loan receivable 2,250,000 1,250,000 Restricted cash 673,204 667,414 Total assets $ 13,770,991 $ 28,718,895 Liabilities and Stockholders’ (Deficit) Equity March 31, 2019 December 31, 2018 Current liabilities $ 16,185,769 $ 26,837,814 Stockholders’ (deficit) equity (2,414,778 ) 1,881,081 Total liabilities and stockholders’ (deficit) equity $ 13,770,991 $ 28,718,895 Statements of Operations Three Months Ended March 31, 2019 Three Months Ended March 31, 2018 Revenues $ 46,406,351 $ 52,983,791 Expenses 50,702,210 54,002,458 Net loss $ (4,295,859 ) $ (1,018,667 )
Universal Care Inc [Member]
Equity Method Investments	UCI’s balance sheets at March 31, 2019 and December 31, 2018 and statements of income for the three months ended March 31, 2019 and 2018 are as follows: Balance Sheets March 31, 2019 December 31, 2018 Assets Cash $ 29,161,538 $ 27,812,520 Receivables, net 49,693,015 46,978,703 Other current assets 32,487,216 18,670,350 Other assets 659,897 661,621 Property and equipment, net 2,943,466 2,786,996 Total assets $ 114,945,132 $ 96,910,190 Liabilities and Stockholders’ Deficit March 31, 2019 December 31, 2018 Current liabilities $ 104,980,771 $ 89,731,133 Other liabilities 25,014,826 25,024,043 Stockholders’ deficit (15,050,465 ) (17,844,986 ) Total liabilities and stockholders’ deficit $ 114,945,132 $ 96,910,190 Statements of Income Three Months Ended March 31, 2019 Three Months Ended March 31, 2018 Revenues $ 113,318,827 $ 72,665,437 Expenses 111,408,456 72,154,950 Income before (benefit from) provision for income taxes 1,910,371 510,487 (Benefit from) provision for income taxes (210,667 ) 551,800 Net income (loss) $ 2,121,038 $ (41,313 )
Accountable Health Care IPA [Member]
Equity Method Investments	Accountable’s balance sheet at March 31, 2019 and December 31, 2018 and statements of operations for the three months ended March 31, 2019 are as follows: Balance Sheets March 31, 2019 December 31, 2018 Assets Cash $ 4,381,055 $ 5,582,837 Receivables, net 11,246,477 11,246,477 Other current assets 30,940 30,940 Other assets 1,312,769 1,312,768 Property and equipment, net 138,690 138,690 Total Assets $ 17,109,931 $ 18,311,712 Liabilities and Stockholders’ Deficit March 31, 2019 December 31, 2018 Current Liabilities $ 18,723,556 $ 16,824,083 Other Liabilities 19,500,000 19,500,000 Stockholders’ deficit (21,113,625 ) (18,012,371 ) Total liabilities and stockholders’ deficit $ 17,109,931 $ 18,311,712 Statement of Operation Three Months Ended March 31, 2019 Revenues $ 22,990,290 Expenses 26,091,544 Loss before provision for income taxes (3,101,254 ) Provision for income taxes - Net loss* $ (3,101,254 ) * APC’s allocation of net loss commenced on September 21, 2018.
531 W. College LLC's [Member]
Equity Method Investments	531 W. College LLC’s balance sheets at March 31, 2019 and December 31, 2018 and the statements of operations for the three months ended March 31, 2019 is as follows: Balance Sheet March 31, 2019 December 31, 2018 Assets Cash 341,969 158,088 Other current assets 78,677 16,137 Other assets 70,000 70,000 Property and equipment, net $ 33,394,792 $ 33,394,792 Total assets $ 33,885,438 $ 33,639,017 Liabilities and Members’ Equity Current liabilities $ 1,433,070 $ 1,007,413 Stockholders’ equity 32,452,368 32,631,604 Total liabilities and members’ equity $ 33,885,438 $ 33,639,017 Statements of Operation March 31, 2019 Revenues - Expenses 468,560 Loss from operations (468,560 ) Other Income $ 289,325 Net loss* $ (179,235 )

Accounts Payable and Accrued _2

Accounts Payable and Accrued Expenses (Tables)	3 Months Ended
	Mar. 31, 2019
Payables and Accruals [Abstract]
Accounts payable and accrued liabilities	The Company’s accounts payable and accrued expenses consisted of the following: March 31, 2019 December 31, 2018 Accounts payable $ 4,750,543 $ 4,481,544 Specialty capitation payable 300,000 300,000 Subcontractor IPA risk pool payable 2,191,664 2,532,750 Professional fees 2,470,583 2,251,741 Due to related parties 568,385 1,488,313 Contract liabilities 33,292,123 9,024,235 Accrued compensation 4,081,173 4,996,906 $ 47,654,471 $ 25,075,489

Medical Liabilities (Tables)

Medical Liabilities (Tables)	3 Months Ended
	Mar. 31, 2019
Disclosure of Medical Liabilities [Abstract]
Medical Liabilities	The Company’s medical liabilities consisted of the following: March 31, 2019 December 31, 2018 Balance, beginning of period $ 33,641,701 $ 63,972,318 Claims paid for previous period (28,850,325 ) (36,549,348 ) Incurred health care costs 34,974,952 209,002,961 Claims paid for current period (16,586,584 ) (167,537,480 ) Payment to CMS based on APAACO 2017 year settlement - (34,464,826 ) Adjustments 86,121 (781,924 ) Balance, end of period $ 23,265,865 $ 33,641,701

Mezzanine and Stockholders' E_2

Mezzanine and Stockholders' Equity (Tables)	3 Months Ended
	Mar. 31, 2019
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions	During the three months ended March 31, 2019, the Company granted 45,000 stock options to certain ApolloMed board members which were recognized at fair value, as determined using the Black-Scholes option pricing model and the following assumptions: March 31, 2019 Expected Term 3.0 Expected volatility 100.27 Risk-free interest rate 2.51 Market value of common stock $ 18.11 Annual dividend yield - Forfeiture rate 0 %
Summary of Share-Based Compensation Expense of Stock Option Awards Granted	Share-based compensation expense related to option awards granted to primary care physicians to purchase shares of APC’s common stock, are recognized over their respective vesting periods, and consisted of the following: Three Months Ended March 31, 2019 2018 Share-based compensation expense: General and administrative $ 202,382 $ 202,382 $ 202,382 $ 202,382
Warrants Outstanding	The Company’s outstanding warrants consisted of the following: Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (in millions) Warrants outstanding at January 1, 2019 3,331,995 $ 9.93 2.97 $ 33.1 Warrants granted - - - - Warrants exercised (11,516 ) 9.81 - 0.1 Warrants expired/forfeited - - - - Warrants outstanding at March 31, 2019 3,320,479 $ 9.93 2.72 $ 27.9 Weighted Weighted Average Average Exercise Price Exercise Price Per Warrants Remaining Warrants Per Share Outstanding Contractual Life Exercisable Share $ 9.00 1,075,492 1.54 1,075,492 9.00 10.00 1,416,085 3.04 1,416,085 10.00 11.00 828,902 3.69 828,902 11.00 $ 9.00 –11.00 3,320,479 2.72 3,320,479 $ 9.93
Exclusivity Amendment Agreement, APC [Member]
Stock Option Transactions Under Stock Option Plans	Outstanding stock options granted to primary care physicians to purchase shares of APC’s common stock consisted of the following: Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (in millions) Options outstanding at January 1, 2019 853,800 $ 0.167 0.75 $ 0.5 Options granted - - - - Options exercised - - - - Options expired/forfeited - - - - Options outstanding and exercisable at March 31, 2019 853,800 $ 0.167 0.50 $ 0.5
Employee Stock Option [Member]
Stock Option Transactions Under Stock Option Plans	The Company’s outstanding stock options consisted of the following: Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Term (Years) Aggregate Intrinsic Value (in millions) Options outstanding at January 1, 2019 647,240 $ 5.62 4.13 $ 9.2 Options granted 45,000 18.11 - - Options exercised (6,000 ) 4.50 - 0.1 Options forfeited - - - - Options outstanding at March 31, 2019 686,240 $ 6.45 3.95 $ 8.1 Options exercisable at March 31, 2019 641,240 $ 5.27 3.64 $ 8.1

Related Party Transactions (Tab

Related Party Transactions (Tables)	3 Months Ended
	Mar. 31, 2019
Related Party Transactions [Abstract]
Schedule of Related Party Transactions	The following table sets forth fees incurred and income received related to AHMC, HSMSO and Aurion Corporation: Three months ended March 31, 2019 2018 AHMC – Risk pool and Capitation $ 11,600,000 $ 19,400,000 HSMSO – Management fees, net (650,000 ) (500,000 ) Aurion – Management fees (100,000 ) (100,000 ) Net total $ 10,850,000 $ 18,800,000

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2019
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	Below is a summary of the earnings per share computations: Three Months Ended March 31, 2019 2018 Earnings per share – basic $ 0.00 $ 0.07 Earnings per share – diluted $ 0.00 $ 0.06 Weighted average shares of common stock outstanding – basic 34,496,622 32,421,467 Weighted average shares of common stock outstanding – diluted 38,074,174 38,098,373
Schedule of Weighted Average Number of Shares	Below is a summary of the shares included in the diluted earnings per share computations: Three Months Ended March 31, 2019 2018 Weighted average shares of common stock outstanding – basic 34,496,622 32,421,467 10% shares held back pursuant to indemnification clause 1,519,805 3,039,749 Stock options 455,381 835,790 Warrants 1,602,366 1,801,367 Weighted average shares of common stock outstanding – diluted 38,074,174 38,098,373

Variable Interest Entities (V_2

Variable Interest Entities (VIEs) (Tables)	3 Months Ended
	Mar. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Variable Interest Entities	The following table includes assets that can only be used to settle the liabilities of APC and the creditors of APC have no recourse to the Company, nor do creditors of the Company have recourse against the assets of APC. These assets and liabilities, with the exception of the investment in a privately held entity that does not report net asset value per share and amounts due to affiliate, which are eliminated upon consolidation with the NMM, are included in the accompanying condensed consolidated balance sheets. March 31, 2019 December 31, 2018 Assets Current assets Cash and cash equivalents $ 52,359,206 $ 71,726,342 Investment in marketable securities 1,074,280 1,066,103 Receivables, net 3,096,946 3,904,586 Receivables, net – related party 51,606,081 45,258,916 Prepaid expenses and other current assets 3,944,518 3,647,654 Total current assets 112,081,031 125,603,601 Noncurrent assets Land, property and equipment, net 9,400,074 9,602,228 Intangible assets, net 56,273,585 58,984,420 Goodwill 56,213,450 56,213,450 Loans receivable – related parties 12,500,000 12,500,000 Investment in a privately held entity that does not report net asset value per share 4,725,000 4,725,000 Investments in other entities – equity method 25,881,231 26,707,404 Restricted cash 740,212 745,470 Right-of-use assets 4,216,800 - Other assets 1,282,090 839,085 Total noncurrent assets 171,232,442 170,317,057 Total assets $ 283,313,473 $ 295,920,658 Current liabilities Accounts payable and accrued expenses $ 5,379,342 $ 6,378,751 Fiduciary accounts payable 2,084,926 1,538,598 Medical liabilities 21,610,483 24,983,110 Income taxes payable 12,706,621 11,621,861 Amount due to affiliate 12,197,167 11,505,680 Bank loan - 40,257 Lease liabilities 840,525 - Capital lease obligations 101,741 101,741 Total current liabilities 54,920,805 56,169,998 Noncurrent liabilities Deferred tax liability 13,360,989 15,693,159 Liability for unissued equity shares 1,185,025 1,185,025 Lease liabilities 3,278,928 Capital lease obligations 492,110 517,261 Total noncurrent liabilities 18,317,052 17,395,445 Total liabilities $ 73,237,857 $ 73,565,443

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2019
Leases [Abstract]
Lease, Cost	The components of lease expense were as follows: Three Months Ended March 31, 2019 Operating lease cost $ 1,102,684 Finance lease cost Amortization of lease expense $ 25,150 Interest on lease liabilities 4,579 Sublease income $ (100,180 ) Total finance lease cost, net $ 1,032,233
Other Information Related To Leases	Other information related to leases was as follows: Three Months Ended March 31, 2019 Supplemental Cash Flows Information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 1,033,514 Operating cash flows from finance leases 4,579 Financing cash flows from finance leases 25,150 Right-of-use assets obtained in exchange for lease obligations: Operating leases 8,855,324 Finance leases - Weighted Average Remaining Lease Term Operating leases 4.30 Finance leases 5.25 Weighted Average Discount Rate Operating leases 6.13 % Finance leases 3.00 %
Schedule Of Future Minimum Lease Payments	Future minimum lease payments under non-cancellable leases as of March 31, 2019 and December 31, 2018 were as follows: March 31, 2019 Operating Leases Finance Leases 2019 (excluding the three months ended March 31, 2019) $ 2,506,838 $ 89,190 2020 2,795,554 118,920 2021 1,595,377 118,920 2022 1,250,897 118,920 2023 971,163 118,920 Thereafter 1,514,842 79,278 Total future minimum lease payments 10,634,671 644,148 Less: imputed interest 2,195,602 50,297 Total lease obligations 8,439,069 593,851 Less: current portion 2,461,924 101,741 Long-term lease obligations $ 5,977,145 $ 492,110 December 31, 2018 Operating Leases Finance Leases 2019 $ 2,848,000 $ 119,000 2020 2,267,000 119,000 2021 783,000 119,000 2022 487,000 119,000 2023 489,000 119,000 Thereafter 243,000 79,000 Total future minimum lease payments 7,117,000 674,000

Description of Business - Addit

Description of Business - Additional Information (Detail) - USD ($)	Jul. 01, 1999	Nov. 15, 2016	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2011	Dec. 31, 2018	Jul. 31, 2016	Jun. 04, 2014
Description Of Business [Line Items]
Proceeds from Issuance of Common Stock			$ 155,000	$ 0
Initial Fixed Term Of Amended and Restated Management and Administrative Services Agreement	30 years
ApolloMed [Member]
Description Of Business [Line Items]
Equity Method Investment, Ownership Percentage			4.89%			4.82%
Concourse Diagnostic Surgery Center, LLC [Member]
Description Of Business [Line Items]
Equity Method Investment, Ownership Percentage					41.59%		43.43%
Payments to Acquire Equity Method Investments					$ 600,000
Universal Care Acquisition Partners, LLC [Member]
Description Of Business [Line Items]
Equity Method Investment, Ownership Percentage								100.00%
International Cancer Center ICC" [Member]
Description Of Business [Line Items]
Proceeds from Issuance of Common Stock		$ 400,000
Equity Method Investment, Ownership Percentage		40.00%

Basis of Presentation - Additio

Basis of Presentation - Additional Information (Detail) - USD ($)	Oct. 01, 2018	Jan. 31, 2018	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Summary Of Significant Accounting Policies [Line Items]
Cash, Uninsured Amount			$ 110,000,000
Marketable Securities, Current			1,143,006		$ 1,127,102
Allowance for Doubtful Accounts Receivable, Current			5,200,000		4,300,000
Goodwill, Impairment Loss			$ 0	$ 0
Equity Method Investment, Significant Influence Description			Significant influence is generally deemed to exist if the Company has an ownership interest in the voting stock of the investee of between 20% and 50%, although other factors, such as representation on the investee’s board of directors, are considered in determining whether the equity method of accounting is appropriate.
Payment Of Revenue	$ 8,300,000	$ 7,300,000
All-Inclusive Population-Based Payments to be Received	5,500,000
Deferred Revenue, Current			$ 33,200,000		9,100,000
Operating Lease, Right-of-Use Asset			8,528,159		$ 0
Contract with Customer, Liability, Revenue Recognized			100,000
Payment of revenue reduce	$ 5,500,000
Impairment of Intangible Assets, Finite-lived			$ 0	$ 0
Variable Interest Entity Percentage			50.00%
Operating Lease, Liability			$ 8,439,069
New Accounting Adoption 842 [Member]
Summary Of Significant Accounting Policies [Line Items]
Operating Lease, Right-of-Use Asset			9,000,000
Operating Lease, Liability			8,900,000
Pacific Ambulatory Surgery Center, LLC [Member]
Summary Of Significant Accounting Policies [Line Items]
Equity Method Investment, Impairment			300,000
Accounts Payable And Accrued Expenses [Member]
Summary Of Significant Accounting Policies [Line Items]
Payment Of Revenue			24,800,000
Other Receivables [Member]
Summary Of Significant Accounting Policies [Line Items]
Reinsurance Recoverables, Including Reinsurance Premium Paid			$ 11,200,000

Disaggregation of Revenue (Deta

Disaggregation of Revenue (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenue	$ 95,757,171	$ 123,923,246
Commercial [Member]
Revenue	31,784,992	105,106,621
Medicare [Member]
Revenue	22,947,690	18,541,115
Medicaid [Member]
Revenue	32,820,500	176,350
Other Third Parties [Member]
Revenue	$ 8,203,989	$ 99,160

Percentage of Net Revenue and T

Percentage of Net Revenue and Total Accounts Receivable (Detail)	3 Months Ended			12 Months Ended
	Mar. 31, 2019	Mar. 31, 2018		Dec. 31, 2018
Sales Revenue, Net | Payor A [Member]
Accounts Receivable And Net Revenue [Line Items]
Concentration Risk, Percentage	17.40%	0.00%	[1]
Sales Revenue, Net | Payor B [Member]
Accounts Receivable And Net Revenue [Line Items]
Concentration Risk, Percentage	15.30%	12.00%
Sales Revenue, Net | Payor C [Member]
Accounts Receivable And Net Revenue [Line Items]
Concentration Risk, Percentage	12.00%	10.90%
Accounts Receivable | Payor D [Member]
Accounts Receivable And Net Revenue [Line Items]
Concentration Risk, Percentage	35.30%			34.10%
Accounts Receivable | Payor E [Member]
Accounts Receivable And Net Revenue [Line Items]
Concentration Risk, Percentage	42.90%			42.20%
[1]	Less than 10% of total net revenues

Carrying Amounts and Fair Value

Carrying Amounts and Fair Values of Company's Financial Instruments (Detail) - USD ($)	Mar. 31, 2019	Dec. 31, 2018
Assets
Assets, Fair Value Disclosure	$ 69,147,538	$ 86,627,847
Fair Value, Inputs, Level 1 [Member]
Assets
Assets, Fair Value Disclosure	69,147,538	86,627,847
Fair Value, Inputs, Level 2 [Member]
Assets
Assets, Fair Value Disclosure	0	0
Fair Value, Inputs, Level 3 [Member]
Assets
Assets, Fair Value Disclosure	0	0
Money Market Funds [Member]
Assets
Assets, Fair Value Disclosure	68,004,532	85,500,745
Money Market Funds [Member] | Fair Value, Inputs, Level 1 [Member]
Assets
Assets, Fair Value Disclosure	68,004,532	85,500,745
Money Market Funds [Member] | Fair Value, Inputs, Level 2 [Member]
Assets
Assets, Fair Value Disclosure	0	0
Money Market Funds [Member] | Fair Value, Inputs, Level 3 [Member]
Assets
Assets, Fair Value Disclosure	0	0
Marketable securities – certificates of deposit
Assets
Assets, Fair Value Disclosure	1,074,280	1,066,103
Marketable securities – certificates of deposit | Fair Value, Inputs, Level 1 [Member]
Assets
Assets, Fair Value Disclosure	1,074,280	1,066,103
Marketable securities – certificates of deposit | Fair Value, Inputs, Level 2 [Member]
Assets
Assets, Fair Value Disclosure	0	0
Marketable securities – certificates of deposit | Fair Value, Inputs, Level 3 [Member]
Assets
Assets, Fair Value Disclosure	0	0
Marketable securities – equity securities
Assets
Assets, Fair Value Disclosure	68,726	60,999
Marketable securities – equity securities | Fair Value, Inputs, Level 1 [Member]
Assets
Assets, Fair Value Disclosure	68,726	60,999
Marketable securities – equity securities | Fair Value, Inputs, Level 2 [Member]
Assets
Assets, Fair Value Disclosure	0	0
Marketable securities – equity securities | Fair Value, Inputs, Level 3 [Member]
Assets
Assets, Fair Value Disclosure	$ 0	$ 0

Intangible Assets, Net - Additi

Intangible Assets, Net - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Finite Lived Intangible Assets Accumulated Amortization Addition	$ 3.9	$ 4.4
Exclusivity [Member]
Finite Lived Intangible Assets Accumulated Amortization Addition	$ 0.1	$ 0.1

Schedule of intangible assets (

Schedule of intangible assets (Detail) - USD ($)	3 Months Ended	12 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Intangible Assets, Gross	$ 144,476,000	$ 144,476,000
Accumulated Amortization	(61,419,342)	(57,600,117)
Intangible Assets, Net	83,056,658	86,875,883
Medicare License | Indefinite-lived Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Intangible Assets, Gross	1,994,000	1,994,000
Accumulated Amortization	0	0
Intangible Assets, Net	1,994,000	1,994,000
Network relationships | Finite-Lived Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Intangible Assets, Gross	109,883,000	109,883,000
Accumulated Amortization	(51,215,352)	(48,361,773)
Intangible Assets, Net	$ 58,667,648	$ 61,521,227
Network relationships | Indefinite-lived Intangible Assets [Member] | Maximum [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted Average Life (Yrs)	15 years	15 years
Network relationships | Indefinite-lived Intangible Assets [Member] | Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted Average Life (Yrs)	11 years	11 years
Trade name | Finite-Lived Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted Average Life (Yrs)	20 years	20 years
Intangible Assets, Gross	$ 1,011,000	$ 1,011,000
Accumulated Amortization	(67,400)	(54,763)
Intangible Assets, Net	$ 943,600	$ 956,237
Management contracts [Member] | Finite-Lived Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted Average Life (Yrs)	15 years	15 years
Intangible Assets, Gross	$ 22,832,000	$ 22,832,000
Accumulated Amortization	(8,031,971)	(7,447,581)
Intangible Assets, Net	$ 14,800,029	15,384,419
Member relationships [Member] | Finite-Lived Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted Average Life (Yrs)	12 years
Intangible Assets, Gross	$ 6,696,000	6,696,000
Accumulated Amortization	(1,555,286)	(1,289,667)
Intangible Assets, Net	$ 5,140,714	$ 5,406,333
Member relationships [Member] | Finite-Lived Intangible Assets [Member] | Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted Average Life (Yrs)		12 years
Patient management platform [Member] | Finite-Lived Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted Average Life (Yrs)	5 years	5 years
Intangible Assets, Gross	$ 2,060,000	$ 2,060,000
Accumulated Amortization	(549,333)	(446,333)
Intangible Assets, Net	$ 1,510,667	$ 1,613,667

Schedule of future amortization

Schedule of future amortization expense (Detail)	Mar. 31, 2019USD ($)
Finite-Lived Intangible Assets [Line Items]
2019	$ 10,661,000
2020	12,671,000
2021	10,960,000
2022	9,448,000
2023	7,790,000
Thereafter	29,532,000
Total	$ 81,062,000

Investments in Other Entities_2

Investments in Other Entities (Equity Method) (Detail) - USD ($)	Mar. 31, 2019	Dec. 31, 2018
Equity Method Investments	$ 34,027,323	$ 34,876,980
Universal Care Inc [Member]
Equity Method Investments	3,673,132	2,635,945
LaSalle Medical Associates IPA [Member]
Equity Method Investments	5,980,923	7,054,888
Diagnostic Medical Group [Member]
Equity Method Investments	2,481,166	2,257,346
Pacific Medical Imaging and Oncology Center, Inc [Member]
Equity Method Investments	1,429,960	1,359,494
Pacific Ambulatory Surgery Center, LLC [Member]
Equity Method Investments	0	285,198
Accountable Health Care IPA [Member]
Equity Method Investments	4,202,958	4,977,957
531 W. College, LLC – related party [Member]
Equity Method Investments	16,226,184	16,273,152
MWN, LLC – related party
Equity Method Investments	$ 33,000	$ 33,000

Investments in Other Entities_3

Investments in Other Entities (Summarized Balance Sheets and Statements of Income) (Detail) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
LaSalle Medical Associates IPA [Member]
Assets
Cash and cash equivalents	$ 204,981		$ 18,444,702
Receivables, net	7,116,487		2,897,337
Other current assets	3,526,319		5,459,442
Loan receivable	2,250,000		1,250,000
Restricted cash	673,204		667,414
Total assets	13,770,991		28,718,895
Liabilities and stockholders' deficit
Current liabilities	16,185,769		26,837,814
Stockholders' (deficit) equity	(2,414,778)		1,881,081
Total liabilities and stockholders' (deficit) equity	13,770,991		28,718,895
Statements of Operation
Revenues	46,406,351	$ 52,983,791
Expenses	50,702,210	54,002,458
Net (loss) income	(4,295,859)	(1,018,667)
Universal Care Inc [Member]
Assets
Cash and cash equivalents	29,161,538		27,812,520
Receivables, net	49,693,015		46,978,703
Other current assets	32,487,216		18,670,350
Other assets	659,897		661,621
Property and equipment, net	2,943,466		2,786,996
Total assets	114,945,132		96,910,190
Liabilities and stockholders' deficit
Current liabilities	104,980,771		89,731,133
Other liabilities	25,014,826		25,024,043
Stockholders' (deficit) equity	(15,050,465)		(17,844,986)
Total liabilities and stockholders' (deficit) equity	114,945,132		96,910,190
Statements of Operation
Revenues	113,318,827	72,665,437
Expenses	111,408,456	72,154,950
Income (loss) before income tax provision (benefit)	1,910,371	510,487
Income tax provision (benefit)	(210,667)	551,800
Net (loss) income	2,121,038	$ (41,313)
Accountable Health Care IPA [Member]
Assets
Cash and cash equivalents	4,381,055		5,582,837
Receivables, net	11,246,477		11,246,477
Other current assets	30,940		30,940
Other assets	1,312,769		1,312,768
Property and equipment, net	138,690		138,690
Total assets	17,109,931		18,311,712
Liabilities and stockholders' deficit
Current liabilities	18,723,556		16,824,083
Other liabilities	19,500,000		19,500,000
Stockholders' (deficit) equity	(21,113,625)		(18,012,371)
Total liabilities and stockholders' (deficit) equity	17,109,931		18,311,712
Statements of Operation
Revenues	22,990,290
Expenses	26,091,544
Income (loss) before income tax provision (benefit)	(3,101,254)
Income tax provision (benefit)	0
Net (loss) income	(3,101,254)
531 W. College, LLC [Member]
Assets
Cash and cash equivalents	341,969		158,088
Other current assets	78,677		16,137
Other assets	70,000		70,000
Property and equipment, net	33,394,792		33,394,792
Total assets	33,885,438		33,639,017
Liabilities and stockholders' deficit
Current liabilities	1,433,070		1,007,413
Stockholders' (deficit) equity	32,452,368		32,631,604
Total liabilities and stockholders' (deficit) equity	33,885,438		33,639,017
Statements of Operation
Revenues	0
Expenses	468,560		875,771
Income (loss) before income tax provision (benefit)	(468,560)		(875,771)
Income tax provision (benefit)	289,325		162,451
Net (loss) income	$ (179,235)		$ (713,320)

Investments in Other Entities -

Investments in Other Entities - Additional Information (Detail) - USD ($)	Apr. 10, 2018	May 14, 2016	Jun. 30, 2018	May 31, 2018	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018	Dec. 18, 2018	Sep. 21, 2018	Nov. 15, 2016	Aug. 10, 2015	Jul. 01, 2015	Dec. 31, 2012	Oct. 15, 2012
Income (Loss) from Equity Method Investments					$ (849,657)	$ (28,024)
Equity Method Investments					$ 34,027,323		$ 34,876,980
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross					45,000
Pacific Ambulatory Surgery Center, LLC [Member]
Accounts and Other Receivables, Net, Current					$ 300,000
Other Assets					300,000
LaSalle Medical Associates IPA [Member]
Equity Method Investments					5,980,923		7,054,888
Pacific Medical Imaging and Oncology Center, Inc [Member]
Equity Method Investment, Ownership Percentage												40.00%
Equity Method Investment, Aggregate Cost												$ 1,200,000
Income (Loss) from Equity Method Investments					70,466	(26,025)
Equity Method Investments					1,429,960		1,359,494
Equity Method Investment, Other than Temporary Impairment					300,000
Pacific Medical Imaging and Oncology Center, Inc [Member] | Ancillary Service Contract [Member]
Payments for Other Fees					700,000	400,000
Universal Care Inc [Member]
Equity Method Investments					3,673,132		2,635,945
Diagnostic Medical Group [Member]
Income (Loss) from Equity Method Investments					200,000	300,000
Equity Method Investments					2,481,166		2,257,346
Payments to Acquire Equity Method Investments		$ 1,600,000
Pacific Ambulatory Surgery Center, LLC [Member]
Equity Method Investments					0		285,198
Equity Method Investment, Other than Temporary Impairment					300,000
MWN Community Hospital LLC [Member]
Equity Method Investment, Ownership Percentage								33.30%
Equity Method Investments					33,000		33,000
Initial Capital Contribution								$ 3,000
Working Capital Contribution								$ 30,000
Accountable Health Care IPA [Member]
Equity Method Investment, Ownership Percentage									25.00%
Income (Loss) from Equity Method Investments					800,000
Equity Method Investments					4,202,958		4,977,957
Investment Owned, Balance, Principal Amount					4,200,000		5,000,000
Accountable Health Care IPA [Member] | Convertible Debt [Member]
Loans Payable									$ 5,000,000
MediPortal LLC [Member]
Warrant to Purchase Term				5-year warrant to purchase 270,000 membership interests
Cost Method Investment Description				In May 2018, APC purchased 270,000 membership interests of MediPortal LLC, a New York limited liability company, for $0.4 million or $1.50 per membership interest, which represented approximately 2.8% ownership.
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross				380,000
Class of Warrant or Right, Number of Securities Called by Warrants or Rights				480,000
College Street Investment LP [Member]
Equity Method Investment, Ownership Percentage			50.00%
Allied Pacific of California [Member]
Equity Method Investment, Ownership Percentage			25.00%
Payments to Escrow Deposit			$ 8,300,000
Members' Capital			$ 8,300,000
Allied Pacific of California [Member] | Convertible Debt [Member]
Loans Payable									5,000,000
Allied Pacific of California [Member] | LaSalle Medical Associates IPA [Member]
Income (Loss) from Equity Method Investments					1,100,000	400,000
Equity Method Investments					6,000,000		7,100,000
Allied Pacific of California [Member] | Universal Care Inc [Member]
Income (Loss) from Equity Method Investments					1,000,000	(20,202)
Equity Method Investments					3,600,000		2,600,000
Allied Pacific of California [Member] | Diagnostic Medical Group [Member]
Income (Loss) from Equity Method Investments					200,000	300,000
Equity Method Investments					2,500,000		$ 2,300,000
Allied Pacific of California [Member] | Pacific Ambulatory Surgery Center, LLC [Member]
Equity Method Investment, Ownership Percentage										40.00%
Equity Method Investment, Aggregate Cost										$ 800,000
Income (Loss) from Equity Method Investments						$ 41,953
Network Medical Management, Inc. [Member]
Equity Method Investment, Ownership Percentage			25.00%
Equity Method Investments									$ 5,000,000
Payments to Escrow Deposit			$ 8,300,000
Members' Capital			8,300,000
APC and NMM [Member]
Equity Method Investments					$ 16,200,000
APC LSMA [Member]
Equity Method Investment, Ownership Percentage		40.00%
APC LSMA [Member] | LaSalle Medical Associates IPA [Member]
Equity Method Investment, Ownership Percentage													25.00%
Equity Method Investment, Aggregate Cost													$ 5,000,000
APC LSMA [Member] | Allied Pacific of California [Member]
Equity Method Investment, Ownership Percentage														100.00%
Universal Care Acquisition Partners, LLC [Member] | Universal Care Inc [Member]
Equity Method Investment, Aggregate Cost											$ 10,000,000
Universal Care Acquisition Partners, LLC [Member] | Allied Pacific of California [Member]
Equity Method Investment, Ownership Percentage											100.00%
AHMC Healthcare Inc [Member]
Payments to Acquire Real Estate	$ 33,300,000
Payments to Escrow Deposit			16,700,000
Members' Capital			$ 16,700,000
Voting Common Stock A Two [Member] | Universal Care Acquisition Partners, LLC [Member] | Universal Care Inc [Member]
Equity Method Investments, Purchase of Shares											100,000
Equity Method Investments, Proportion of Ownership Interest in Voting Common Stock											50.00%
Voting Common Stock A Two [Member] | Universal Care Acquisition Partners, LLC [Member] | Universal Care Inc [Member] | Ancillary Service Contract [Member]
Equity Method Investment, Ownership Percentage											48.90%

Loan Receivable - Related Par_2

Loan Receivable - Related Parties - Additional Information (Detail) - USD ($)	3 Months Ended	12 Months Ended
	Mar. 31, 2019	Dec. 31, 2018	Nov. 28, 2018	Sep. 21, 2018	Jun. 29, 2018	Oct. 09, 2017
Debt Instrument, Interest Rate, Stated Percentage	6.50%
Extendable Amount On Credit Facility	$ 8,000,000
Percentage Of Managing Responsible Of Health Plan ship	100.00%
Universal Care Inc [Member]
Debt Instrument, Interest Rate, Basis for Effective Rate	prime rate plus 1%	prime rate plus 1%
Advanced For Working Capital	$ 5,000,000
Line of Credit Facility Additional Advances			$ 5,000,000		$ 2,500,000
Loans and Leases Receivable, Related Parties	12,500,000	$ 12,500,000
APC [Member]
Loans Receivable, Net						$ 5,000,000
Long-term Line of Credit				$ 5,000,000		5,000
Payments to Acquire Loans Receivable	5,000,000
NMM Business Loan Agreement [Member]
Long-term Line of Credit	$ 13,000,000	$ 13,000,000		$ 5,000,000		5,000,000
Network Medical Management, Inc. [Member]
Loans Receivable, Net						5,000,000
Equity Method Investment, Ownership Percentage				25.00%
APC and NMM [Member]
Loans Payable				$ 5,000,000
Dr. Jay Loan [Member]
Loans Receivable, Net						$ 10,000,000
Debt Instrument, Interest Rate, Basis for Effective Rate	prime rate plus 1%
Debt Instrument, Interest Rate, Stated Percentage		6.50%
Debt Instrument, Payment Terms	Interest on the Dr. Jay Loan accrues at a rate that is equal to the prime rate plus 1% (6.50% as of March 31, 2019 and December 31, 2018) and payable in monthly installments of interest only on the first day of each month until the date that is three years following the initial date of funding, at which time, all outstanding principal and accrued interest thereon shall be due and payable in full.
Debt Instrument, Convertible, Terms of Conversion Feature	At any time on or before the date that is one year following the initial funding date of the Dr. Jay Loan, APC-LSMA or its designee have the right, but not the obligation, to convert up to $5.0 million of the outstanding principal amount into shares of Accountable’s capital stock. At any time after the date that is one year following the funding date, the Dr. Jay Loan may be prepaid at any time. Within three years following the initial funding of the Dr. Jay Loan, APC-LSMA or its designee shall have the right, but not the obligation, to convert the then outstanding principal amount into Accountable shares based on Accountable’s then-current valuation.

Accounts Payable and Accrued _3

Accounts Payable and Accrued Expenses (Detail) - USD ($)	Mar. 31, 2019	Dec. 31, 2018
Account Payable And Accrued Liabilities [Line Items]
Accounts payable	$ 4,750,543	$ 4,481,544
Specialty capitation payable	300,000	300,000
Subcontractor IPA risk pool payable	2,191,664	2,532,750
Professional fees	2,470,583	2,251,741
Due to related parties	568,385	1,488,313
Contract liabilities	33,292,123	9,024,235
Accrued compensation	4,081,173	4,996,906
Accounts payable and accrued liabilities	$ 47,654,471	$ 25,075,489

Medical Liabilities (Detail)

Medical Liabilities (Detail) - USD ($)	3 Months Ended	12 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Balance, beginning of period	$ 33,641,701	$ 63,972,318
Claims paid for previous period	(28,850,325)	(36,549,348)
Incurred health care costs	34,974,952	209,002,961
Claims paid for current period	(16,586,584)	(167,537,480)
Payment to CMS based on APAACO 2017 year settlement	0	(34,464,826)
Adjustments	86,121	(781,924)
Balance, end of period	$ 23,265,865	$ 33,641,701

Bank Loan and Lines of Credit -

Bank Loan and Lines of Credit - Additional Information (Detail) - USD ($)

Oct. 03, 2018

Mar. 03, 2017

Mar. 31, 2019

Apr. 17, 2019

Dec. 31, 2018

Sep. 21, 2018

Sep. 05, 2018

Sep. 01, 2018

Jun. 29, 2018

Jun. 14, 2018

Oct. 09, 2017

Dec. 31, 2010

Debt Instrument, Interest Rate, Stated Percentage

6.50%

Line of Credit Facility, Maximum Borrowing Capacity

$ 6,600,000

$ 6,700,000

Line of Credit Facility, Description

The letter of credit expires on December 31, 2019 and is deemed automatically extended without amendment for additional one - year periods from the present or any future expiration date, unless notified by the institution to terminate prior to 90 days from any expiration date.

The letter of credit expired on December 31, 2018 and was deemed automatically extended without amendment for additional one - year periods from the present or any future expiration date, unless notified by the institution to terminate prior to 90 days from any expiration date.

ICC [Member]

Debt Instrument, Face Amount

$ 4,600,000

Debt Instrument, Interest Rate, Stated Percentage

5.50%

ICC [Member] | Standby Letters of Credit [Member]

Debt Instrument, Maturity Date

Dec. 31, 2018

APC [Member]

Long-term Line of Credit

$ 5,000,000

$ 5,000

APC [Member] | Standby Letters of Credit [Member]

Line of Credit Facility, Maximum Borrowing Capacity

$ 300,000

NMM Business Loan Agreement [Member]

Line of Credit Facility, Maximum Borrowing Capacity

$ 20,000,000

Line of Credit Facility, Interest Rate at Period End

5.625%

5.625%

Line of Credit Facility, Expiration Date

Jun. 22, 2020

Long-term Line of Credit

$ 13,000,000

$ 13,000,000

$ 5,000,000

$ 5,000,000

Line of Credit Facility, Remaining Borrowing Capacity

$ 700,000

$ 700,000

Line of Credit Facility, Description

prime rate plus 0.125%

Line of Credit Facility, Guarantee Given by Related Parties

$ 5

NMM Business Loan Agreement [Member] | Minimum [Member]

Line of Credit Facility, Maximum Borrowing Capacity

$ 20,000,000

NMM Business Loan Agreement [Member] | Maximum [Member]

Line of Credit Facility, Maximum Borrowing Capacity

$ 27,000,000

APC Business Loan Agreement [Member]

Line of Credit Facility, Maximum Borrowing Capacity

$ 10,000,000

Line of Credit Facility, Interest Rate at Period End

5.625%

5.625%

Line of Credit Facility, Expiration Date

Jun. 22, 2020

Line of Credit Facility, Remaining Borrowing Capacity

$ 9,700,000

$ 9,700,000

Line of Credit Facility, Description

prime rate plus 0.125%

APC Business Loan Agreement [Member] | Subsequent Event [Member] | Minimum [Member]

Line of Credit Facility, Maximum Borrowing Capacity

$ 10,000,000

APC Business Loan Agreement [Member] | Subsequent Event [Member] | Maximum [Member]

Line of Credit Facility, Maximum Borrowing Capacity

40,000,000

APAACO [Member] | Standby Letters of Credit [Member]

Line of Credit Facility, Expiration Date

Dec. 31, 2018

Net work Medical Management [Member]

Line of Credit Facility, Maximum Borrowing Capacity

$ 20,000,000

Line of Credit Facility, Interest Rate at Period End

5.625%

5.625%

Line of Credit Facility, Expiration Date

Sep. 5, 2019

Line of Credit Facility, Remaining Borrowing Capacity

$ 20,000,000

Line of Credit Facility, Description

prime rate plus 0.125%

Net work Medical Management [Member] | Subsequent Event [Member] | Minimum [Member]

Line of Credit Facility, Maximum Borrowing Capacity

16,000,000

Net work Medical Management [Member] | Subsequent Event [Member] | Maximum [Member]

Line of Credit Facility, Maximum Borrowing Capacity

$ 20,000,000

Mezzanine and Stockholders' E_3

Mezzanine and Stockholders' Equity - Additional Information (Detail) - USD ($)	1 Months Ended		3 Months Ended
	Dec. 31, 2018	Dec. 18, 2018	Mar. 31, 2019	Mar. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period			6,000	75,000
Stock Issued During Period, Shares, Merger			480,212
Treasury Stock, Common, Shares	1,850,603		1,944,054
Repurchase of common shares			$ 40,000	$ 0
Share based Compensation Arrangement By Share based Payment Award Cashless Options Exercises In Period			54,536
Share based Compensation Arrangement By Share based Payment Award Cashless Options Exercises In Period Net			43,201
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Weighted Average Exercise Price			$ 4.50
Share based Compensation Arrangement By Share based Payment Award Warrants Exercises In Period			11,516
Warrant Issued During Period Value Stock Options Exercised			$ 100,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross			45,000
Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Weighted Average Exercise Price				$ 2.10
Share based Compensation Arrangement By Share based Payment Award Warrant Exercisable Weighted Average Exercise Price			9
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Weighted Average Exercise Price				$ 10
Share based Compensation Arrangement By Share based Payment Award Warrant Exercisable Weighted Average Exercise Price			11
Allied Pacific of California [Member]
Treasury Stock, Common, Shares	1,682,110		1,775,561
Repurchase of common shares		$ 1,700,000
Stock Repurchased and Retired During Period, Shares		1,662,571
Stock Compensation Plan [Member]
Share based Compensation Arrangement By Share based Payment Award Options Grant Weighted Average Remaining Contractual Term			6 months
Restricted Stock Units (RSUs) [Member]
Share-based Compensation			$ 100,000
APC Stock Option [Member]
Stock Issued During Period, Value, Stock Options Exercised			27,000	$ 500,000
APC Common Stock [Member]
Payments of Ordinary Dividends, Common Stock			10,000,000	$ 2,000,000
APCN share Holder [Member]
Treasury Stock, Shares, Acquired	168,493
Network Medical Management, Inc 'NMM' [Member] | Stock Compensation Plan [Member]
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized			$ 400,000
Holdback Shares [Member]
Treasury Stock, Common, Shares			93,451

Schedule of Stock Options Activ

Schedule of Stock Options Activity (Detail) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended		12 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Shares
Options exercised	(6,000)	(75,000)
Employee Stock Option [Member]
Shares
Beginning balance	647,240
Options granted	45,000
Options exercised	(6,000)
Options forfeited	0
Ending balance	686,240		647,240
Options exercisable	641,240
Weighted Average Exercise Price
Beginning balance	$ 5.62
Options granted	18.11
Options exercised	4.50
Options forfeited	0
Ending balance	6.45		$ 5.62
Options exercisable	$ 5.27
Weighted Average Remaining Contractual Term (Years)
Options outstanding	3 years 11 months 12 days		4 years 1 month 17 days
Options exercisable	3 years 7 months 20 days
Aggregate Intrinsic Value
Beginning Balance	$ 9.2
Options exercised	0.1
Ending balance	8.1		$ 9.2
Options exercisable	$ 8.1
Allied Pacific of California [Member]
Shares
Beginning balance	853,800
Options granted	0
Options exercised	0
Options forfeited	0
Ending balance	853,800		853,800
Weighted Average Exercise Price
Beginning balance	$ 0.167
Options granted	0
Options exercised	0
Options forfeited	0
Ending balance	$ 0.167		$ 0.167
Weighted Average Remaining Contractual Term (Years)
Options outstanding	6 months		9 months
Aggregate Intrinsic Value
Beginning Balance	$ 0.5
Ending balance	$ 0.5		$ 0.5

Summary of Stock Option Activit

Summary of Stock Option Activity Under Black-Scholes Option (Detail)	3 Months Ended
	Mar. 31, 2019$ / shares
Expected term	3 years
Expected volatility	100.27%
Risk-free interest rate	2.51%
Market value of common stock	$ 18.11
Annual dividend yield	0.00%
Forfeiture rate	0.00%

Summary of Remaining Unrecogniz

Summary of Remaining Unrecognized Share based Compensation of Stock Option (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Allocated Share-based Compensation Expense	$ 345,134	$ 833,944
General and Administrative Expense [Member]
Allocated Share-based Compensation Expense	$ 202,382	$ 202,382

Summary of Warrant (Detail)

Summary of Warrant (Detail) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Shares [Abstract]
Number of warrants, Outstanding	3,331,995
Warrants granted	0
Warrants exercised	(11,516)
Warrants forfeited	0
Number of warrants, Outstanding	3,320,479	3,331,995
Weighted Average Exercise Price [Abstract]
Warrants outstanding Balance	$ 9.93
Warrants granted	0
Warrants exercised	9.81
Warrants forfeited	0
Warrants outstanding Balance	$ 9.93	$ 9.93
Weighted Average Remaining Contractual Term Years [Abstract]
Warrants outstanding Balance	2 years 8 months 19 days	2 years 11 months 19 days
Aggregate Intrinsic Value [Abstract]
Warrants outstanding Balance	$ 27.9	$ 33.1
Warrants granted	0
Warrants exercised	0.1
Warrants forfeited	$ 0

Warrants (Detail)

Warrants (Detail)	3 Months Ended
	Mar. 31, 2019$ / sharesshares
Warrant Exercise Price Range One 9.00
Class of Warrant or Right [Line Items]
Warrants outstanding	1,075,492
Weighted average remaining contractual life	1 year 6 months 14 days
Warrants exercisable	1,075,492
Weighted average exercise price per share | $ / shares	$ 9
Warrant Exercise Price Range Two 10.00
Class of Warrant or Right [Line Items]
Warrants outstanding	1,416,085
Weighted average remaining contractual life	3 years 14 days
Warrants exercisable	1,416,085
Weighted average exercise price per share | $ / shares	$ 10
Warrant Exercise Price Range Three 11.00
Class of Warrant or Right [Line Items]
Warrants outstanding	828,902
Weighted average remaining contractual life	3 years 8 months 8 days
Warrants exercisable	828,902
Weighted average exercise price per share | $ / shares	$ 11
Warrant Exercise Price Range Four 9.00 - 10.00
Class of Warrant or Right [Line Items]
Warrants outstanding	3,320,479
Weighted average remaining contractual life	2 years 8 months 19 days
Warrants exercisable	3,320,479
Weighted average exercise price per share | $ / shares	$ 9.93

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - USD ($) $ in Millions	Apr. 03, 2018	Mar. 23, 2018	Mar. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Commitments And Contingencies [Line Items]
Loss Contingency, Damages Sought, Value	$ 5	$ 5
Percentage Of Financial Guarantee Benchmark Amount			2.00%
Standby Letters of Credit [Member]
Commitments And Contingencies [Line Items]
Long-term Line of Credit			$ 0.3
Preferred Bank [Member]
Commitments And Contingencies [Line Items]
Long-term Line of Credit				$ 6.6	$ 6.7

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Nov. 28, 2018	Jun. 28, 2018	Nov. 16, 2015
LMA [Member]
Equity Method Investment, Ownership Percentage	25.00%
Revenue from Related Parties	$ 3,200,000	$ 4,600,000
Service [Member] | PMIOC [Member]
Payment Made To Related Party	700,000	400,000
Service [Member] | AMG, Inc [Member]
Payment Made To Related Party	1,300,000	700,000
Service [Member] | DMG [Member]
Payment Made To Related Party	2,000,000	1,600,000
Universal Care Inc [Member]
Accounts and Other Receivables, Net, Current					$ 5,000,000
Equity Method Investment, Ownership Percentage					48.90%
Advance Diagnostic Surgery Center [Member] | Service [Member]
Payment Made To Related Party	92,000	22,000
Medical Property Partners [Member]
Payment Made To Related Party	300,000	300,000
Medical Investment Group LLC [Member]
Payment Made To Related Party		90,000
APC Shareholders [Member] | Service [Member]
Payment Made To Related Party	$ 9,300,000	9,200,000
APC Shareholders [Member] | Service [Member] | PMIOC [Member]
Equity Method Investment, Ownership Percentage	40.00%
APC Shareholders [Member] | Service [Member] | DMG [Member]
Equity Method Investment, Ownership Percentage	40.00%
Shareholders And Officers [Member]
Payment Made To Related Party	$ 3,300,000	2,300,000
Universal Care Acquisition Partners, LLC [Member]
Accounts and Other Receivables, Net, Current			$ 5,000,000	$ 2,500,000
Critical Quality Management Corp [Member]
Payment Made To Related Party	100,000	35,000
Numen LLC [Member]
Payment Made To Related Party	100,000	100,000
AHMC [Member]
Revenue from Related Parties	10,100,000	18,000,000
Deferred Revenue, Revenue Recognized	$ 49,800,000	$ 44,200,000

Related Party Transactions (Det

Related Party Transactions (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Receipts, Net	$ 10,850,000	$ 18,800,000
AHMC
AHMC – Risk pool revenue	11,600,000	19,400,000
HSMSO
Management fees, net	(650,000)	(500,000)
Aurion
Management fees, net	$ (100,000)	$ (100,000)

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Detail) - shares	3 Months Ended	12 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Antidilutive Securities Excluded from Computation of Earnings Per Share, Shares	1,775,561	1,682,110

Basic Net Income (loss) Per Sha

Basic Net Income (loss) Per Share is Calculated Using Weighted Average Number of Shares (Detail) - $ / shares	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Earnings per share – basic	$ 0	$ 0.07
Earnings per share – diluted	$ 0	$ 0.06
Weighted average shares of common stock outstanding – basic	34,496,622	32,421,467
Weighted average shares of common stock outstanding – diluted	38,074,174	38,098,373

Summary of Shares Included in D

Summary of Shares Included in Diluted Earnings Per Share (Detail) - shares	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Weighted average shares of common stock outstanding – basic	34,496,622	32,421,467
Weighted average shares of common stock outstanding - diluted	38,074,174	38,098,373
Employee Stock Option [Member]
Weighted Average Number Diluted Shares Outstanding Adjustment	455,381	835,790
Common Stock [Member]
Weighted Average Number Diluted Shares Outstanding Adjustment	1,519,805	3,039,749
Warrant [Member]
Weighted Average Number Diluted Shares Outstanding Adjustment	1,602,366	1,801,367

Eliminated Upon Consolidation I

Eliminated Upon Consolidation Included In Accompanying Consolidated Balance Sheets (Detail) - USD ($)	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2018	Dec. 31, 2017
Current assets
Cash and cash equivalents	$ 93,007,780	$ 106,891,503	$ 103,731,761
Investment in marketable securities	1,143,006	1,127,102
Receivables, net	6,640,236	7,127,217
Prepaid expenses and other current assets	7,984,419	7,385,098
Total current assets	176,912,063	172,862,792
Noncurrent assets
Land, property and equipment, net	12,332,342	12,721,082
Intangible assets, net	83,056,658	86,875,883
Goodwill	185,805,880	185,805,880
Loans receivable – related parties	17,500,000	17,500,000
Investments in other entities – equity method	34,027,323	34,876,980
Restricted cash	740,212	745,470	$ 745,293
Right-of-use asset	8,528,159	0
Other assets	1,551,359	1,205,962
Total noncurrent assets	343,946,933	340,136,257
Total assets	520,858,996	512,999,049
Current liabilities
Accounts payable and accrued expenses	47,654,471	25,075,489
Fiduciary accounts payable	2,084,926	1,538,598
Medical liabilities	23,265,865	33,641,701		$ 63,972,318
Bank loan	0	40,257
Lease liabilities	2,461,924	0
Total current liabilities	88,400,766	72,019,647
Noncurrent liabilities
Deferred tax liability	16,992,790	19,615,935
Liability for unissued equity shares	1,185,025	1,185,025
Lease liabilities	5,977,145	0
Total noncurrent liabilities	37,647,070	34,318,221
Total liabilities	126,047,836	106,337,868
Variable Interest Entity, Primary Beneficiary [Member]
Current assets
Cash and cash equivalents	52,359,206	71,726,342
Investment in marketable securities	1,074,280	1,066,103
Receivables, net	3,096,946	3,904,586
Receivables, net – related party	51,606,081	45,258,916
Prepaid expenses and other current assets	3,944,518	3,647,654
Total current assets	112,081,031	125,603,601
Noncurrent assets
Land, property and equipment, net	9,400,074	9,602,228
Intangible assets, net	56,273,585	58,984,420
Goodwill	56,213,450	56,213,450
Loans receivable – related parties	12,500,000	12,500,000
Investment in a privately held entity that does not report net asset value per share	4,725,000	4,725,000
Investments in other entities – equity method	25,881,231	26,707,404
Restricted cash	740,212	745,470
Right-of-use asset	4,216,800	0
Other assets	1,282,090	839,085
Total noncurrent assets	171,232,442	170,317,057
Total assets	283,313,473	295,920,658
Current liabilities
Accounts payable and accrued expenses	5,379,342	6,378,751
Fiduciary accounts payable	2,084,926	1,538,598
Medical liabilities	21,610,483	24,983,110
Income taxes payable	12,706,621	11,621,861
Amount due to affiliate	12,197,167	11,505,680
Bank loan	0	40,257
Lease liabilities	840,525	0
Capital lease obligations	101,741	101,741
Total current liabilities	54,920,805	56,169,998
Noncurrent liabilities
Deferred tax liability	13,360,989	15,693,159
Liability for unissued equity shares	1,185,025	1,185,025
Lease liabilities	3,278,928
Capital lease obligations	492,110	517,261
Total noncurrent liabilities	18,317,052	17,395,445
Total liabilities	$ 73,237,857	$ 73,565,443

Leases - Additional information

Leases - Additional information (Detail)	3 Months Ended
	Mar. 31, 2019USD ($)
Lessee, Finance Lease, Option to Extend	options to extend the leases for up to 10 years
Lessee, Finance Lease, Option to Terminate	options to terminate the leases within one year
Capital Leased Assets, Gross	$ 0.6
Capital Leases, Lessee Balance Sheet, Assets by Major Class, Accumulated Depreciation	$ 0.2
Maximum [Member]
Finance Lease Remaining Lease Term	5 years
Minimum [Member]
Finance Lease Remaining Lease Term	1 month

Components of leases expense (D

Components of leases expense (Detail)	3 Months Ended
	Mar. 31, 2019USD ($)
Operating lease cost	$ 1,102,684
Finance lease cost
Amortization of lease expense	25,150
Interest on lease liabilities	4,579
Sublease income	(100,180)
Total finance lease cost, net	$ 1,032,233

Other information related to le

Other information related to leases (Details)	3 Months Ended
	Mar. 31, 2019USD ($)
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 1,033,514
Operating cash flows from finance leases	4,579
Financing cash flows from finance leases	25,150
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	8,855,324
Finance leases	$ 0
Weighted Average Remaining Lease Term
Operating leases	4 years 3 months 18 days
Finance leases	5 years 3 months
Weighted Average Discount Rate
Operating leases	6.13%
Finance leases	3.00%

Future Minimum Payments Under N

Future Minimum Payments Under Non-cancelable Capital Lease (Detail) - USD ($)	Mar. 31, 2019	Dec. 31, 2018
Operating Leases
2019	$ 2,506,838	$ 2,848,000
2020	2,795,554	2,267,000
2021	1,595,377	783,000
2022	1,250,897	487,000
2023	971,163	489,000
Thereafter	1,514,842	243,000
Total future minimum lease payments	10,634,671	7,117,000
Less imputed interest	2,195,602
Total lease obligations	8,439,069
Less: current portion	2,461,924	0
Long-term lease obligations	5,977,145	0
Finance Leases
2019	89,190	119,000
2020	118,920	119,000
2021	118,920	119,000
2022	118,920	119,000
2023	118,920	119,000
Thereafter	79,278	79,000
Total future minimum lease payments	644,148	674,000
Less imputed interest	50,297
Total lease obligations	593,851
Less: current portion	101,741	101,741
Long-term lease obligations	$ 492,110	$ 517,261

Subsequent Event - Additional I

Subsequent Event - Additional Information (Detail) - USD ($) $ in Millions	1 Months Ended
	Apr. 23, 2019	Apr. 17, 2019	Oct. 03, 2018	Jun. 30, 2018	Mar. 03, 2017
Subsequent Event [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity			$ 6.6		$ 6.7
Allied Pacific of California [Member]
Subsequent Event [Line Items]
Equity Method Investment, Ownership Percentage				25.00%
Five three one W college llc [Member] | Allied Pacific of California [Member]
Subsequent Event [Line Items]
Equity Method Investment, Ownership Percentage	50.00%
Equity Method Investment, Aggregate Cost	$ 16.2
Five three one W college llc [Member] | Network Medical Management, Inc 'NMM' [Member] | Allied Pacific of California [Member]
Subsequent Event [Line Items]
Business Acquisition, Percentage of Voting Interests Acquired	25.00%
Business Combination, Consideration Transferred	$ 8.3
Subsequent Event [Member] | Allied Pacific of California [Member] | Maximum [Member]
Subsequent Event [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity		$ 40
Subsequent Event [Member] | Allied Pacific of California [Member] | Minimum [Member]
Subsequent Event [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity		10
Subsequent Event [Member] | Network Medical Management, Inc 'NMM' [Member] | Maximum [Member]
Subsequent Event [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity		20
Subsequent Event [Member] | Network Medical Management, Inc 'NMM' [Member] | Minimum [Member]
Subsequent Event [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity		$ 16